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INDEX TO VOLUME SIXTY-FIVE 



JANUARY-DECEMBER 1969 




ABSTRACTING AND INDEXING 

Index of Canadian nursing studies available, 
16 (Jun) 

ACCREDITATION 

CCHA rejects CNA bid for representation, 9 
(Jun) 

AIKEN. Ruth E. 

Bk. rev., 56 (May) 

AISH, Arlene 

Joined staff of Queen's University, (port), 
22 (Oct) 

ALBERTA ASSOCIATION OF 
REGISTERED NURSES 

Alberta and British Columbia announce 

contributions to ICN, 13 (Mar) 
Alberta nurses accept new contract, 15 

(Sep) 
Holds district rallies to study bill 119, IS 

(Nov) 
ICN receives $8,000 from AARN, 9 (Jun) 
Membership increases in 1968, 8 (Jul) 
"Nurse in Society" is AARN convention 

theme, 10 (Aug) 
Presents brief to cabinet, 1 3 (Apr) 
Rejects bill 119 will meet with health 

minister, 13 (Dec) 

ALCOHOLISM 

A comparison of the perceptions of public 
health nurses and their alcoholic pa- 
tients . . . (Williams), (abst), 52 (May) 

ALEXANDER, Mary 
Bk. rev., 37 (Jul) 

ALLAIRE, Virginie, Mother 

Obituary, (port), 22 (Apr) 

AMERICAN NURSES' ASSOCIATION 

ANA releases current RN data, 16 (Dec) 

ANA supports AMA's move against discri- 
mination, 16 (Mar) 

Interim executive director appointed by 
ANA, 19 (Aug) 

A look at ana's legislative program, (Linda- 
bury), 22 (Jul) 

AMPUTATION 

The amputee and immediate prosthesis, 
(Shewchuk, Young), 47 (May) 

ANDERSON, Patricia S. B. 

Lecturer, school of nursing, Queen's Univer- 
sity, 20 (May) 

ANDRAS, Andy 

Health care fragmented labor leader tells 
assembly, 1 1 (Nov) 

ANGUS, M. D. 

Aging and learning, 41 (Nov) 

ANNABLE, Charlotte A. 

Instructor, Sask. Institute of Applied Sci- 
ences, 22 (Apr) 

ANTISEPSIS 

OR nurses discuss infection in hospitals, 10 
(Feb) 

ARCHITECTURE 

see Hospitals - Planning and construction 



ARNOLD, Gail A. 

Helping the patient face reality, 41 (Sep) 

ARPIN, Kathleen 

RNANS considers principles of curriculum 
building, 8 (Jul) 

ASSOCIATION OF NURSES OF 
PRINCE EDWARD ISLAND 

Holds annual meeting, 10 (Aug) 

ASSOCIATION OF NURSES OF 
THE PROVINCE OF QUEBEC 

CEGEP system explained at ANPQ general 

meeting, 9 (Jan) 
Committees discuss uniform nursing tech- 
niques, 13 (Jan) 
Donates $50,000 to ICN congress, 12 (Mar) 
Elects new offices, 1 8 (Dec) 

Professional liability insurance available to 

ANPQ members, 12 (Apr) 
To study nursing profession in Quebec. 10 

(Sep) 
Two scholarships offered in Quebec, 16 

(May) 

ASSOCIATION OF OPERATING 
ROOM TECHNICIANS 

OR technicians form association, 12 (Oct) 
Robert W. Hades elected first president, 
12 (Oct) 

ASSOCIATION OF REGISTERED 

NURSES OF NEWFOUNDLAND 

Moves to new headquarters, 14 (Feb) 
Newfoundland donates $1,840 to CNA for 
ICN costs, 9 (May) 

ATTITUDES 

Quality of care makes the difference, 
(Matthews), 50 (Nov) 

Relationship between attitude and person- 
centeredness of nursing care, (Perry) 
(abst), 44 (Dec) 

Relationships between attitudes to nurs- 
ing .. . (Bailey), (abst), 52 (May) 

AUDIO VISUAL AIDS 

AV-aids for nursing subject of US study, 10 

(Feb) 
Don't push your luck, 53 (Nov) 
Electronic video recording simplifies film 

showing, 14 (Feb) 
Emergency 77, 39 (Jul) 
Hyperbaric fire control - fire behavior and 

extinguishment in hyperbaric chambers, 

39 (Jul) 
Immediate post-surgical prosthesis, 39 (Jul) 
The minis have it, (Hill), 44 (Nov) 
A new handbook of educational material for 

guidance, health, and sex education, 52 

(Jan) 
Overcoming resistance to change, 39 (Jul) 
RNAO holds regional conferences on audio- 
visual aids, 9 (Jan) 
Surgical film catalog. 52 (Jan) 
The way I see it, 39 (Jul) 

AUXILIARY WORKERS 

OR technicians form association, 12 (Oct) 

AWARDS 

CNF announces scholarship winners, 9 (Sep) 
CNF scholarship fund drops to $25,000 for 
1969, 7 (Feb) 



Canadian Red Cross established nursing 

fellowship, 15 (Jul) 
Good Citizenship award in Victoria, B.C , 

18 (Sep) 

Jean C. Leask recipient of the R.D. Defries 

Award, 16 (Jul) 
MARN awards bursaries, 16 (Dec) 
Male student wins recruitment poster 

contest, 14 (Jul) 
NBARN awards scholarships, 21 (Nov) 
Nicole Du Mouchel awarded the Warner- 

Chilcott scholarship, 19 (Jan) 
Nursing sister receives OBE, 1 7 (Mar) 
RNABC announces awards, 21 (Nov) 
RNABC loans offered, 16 (May) 
Red cross bursary offered to Ontario nurses, 

19 (Apr) 

St. John Ambulance announces bursary 
awards, 1 1 (Oct) 

3M donates fellowship, 10 (Aug) 

Too Uttle, for too long, from federal govern- 
ment, (Good), 29 (May) 

Two scholarships offered in Quebec, 16 
(May) 

White Sister donates $30,000 scholarship, 
10 (Aug) 

B 

BAILEY, A. Joyce 

Relationships between attitudes to nurs- 
ing . . .(abst), 52 (May) 

BALL, Charles 

Bk. rev., 41 (Mar) 

Ban, Laura 

Nursing associations - are they coming or 

going? (Zilm), 31 (Sep) 
Whoo-Fur pinned down at last, 9 (Jun) 

BARRAS, Marilyn 

Appointed director of nursing, Humber 
College of Applied Arts & Technology, 
Toronto, (port), 22 (Aug) 

BARRON, Purification 

Lecturer, (port), 18 (Sep) 

BEAUDRY-JOHNSON, Nicole 

New services help patients and staff, 39 
(Mar) 

BEGALKE, Rose-Aline 

Instructor, Sask. Institute of Applied Sci- 
ences, 22 (Apr) 

BENNETT, Maureen 

Bk. rev., 47 (Dec) 

BESWETHERICK, Margaret Ann 

Professor, University of Alberta, (port), 22 
(Feb) 

BHADURI, Basanti 

Lecturer, (port), 1 8 (Sep) 

BIEBER, Ottilia M. 

Appointed public health nursing education 
consultant, (port), 19 (Jan) 

BIRLEY, James B. 

Bk. rev., 56 (May) 

BIRTH CONTROL 

Libcrian government doubtful of family 
planning clinics, 1 7 (Aug) 

III 



BLAIR, Heather 

Bk. rcv.,50(Jun) 

BLOOD 

Canada's rare blood bank, (Carter), 35 (Mar) 
The coagulation of Harry, 38 (Oct) 
How much bleeding? (Bruser), 44 (Jan) 

BONDY, Doreen M. 

Family health service: the PHN and the GP, 
(Jones), 38 (Sep) 

BOOK REVIEWS 

Addiction Research Foundation, A prelimi- 
nary report, on the attitudes and behav- 
iour of Toronto students in relation to 
drugs, 5 1 (Oct) 

Alford, Harold J., Continuing education in 
action, 59 (May) 

AUgire, Mildred J., Nurses can give and 
teach rehabilitation, 41 (Mar) 

Alyn, Irene Barrett, Saunders tests for self 
evaluation of nursing competence, (Gil- 
lies), 68 (Feb) 

American Hospital Association, Infection 
control in the hospital, 66 (Feb) 

American Nurses' Association, ANA region- 
al clinical conferences, 50 (Jan) 

American Psychiatric Association, A 
psychiatric glossary, 51 (Nov) 

Andreoli, Kathleen G. et al, Comprehensive 
cardiac care, 37 (Jul) 

Asperheim, Mary Kaye, The pharmacologic 
basis of patient care, 50 (Aug) 

Avery, Mary Ellen, The lung and its disord- 
ers in the newborn infant, 52 (Jan) 

Azneer, J. Leonard, (Kessler, Caccamo), 

Resuscitation: a programmed course, 52 

(Jan) 

Barnes, Elizabeth Psychosocial nursing, 54 
(Sep) 

Btishen, Bernard R., Doctors and doctrines, 
51 (Oct) 

Bloom, Arnold, Toohey medicine for 
nurses, 47 (Dec) 

Bowen, Eleanor Page, Biology of human 
behavior, 52 (Jan) 

Bowley, Agatha H., The young handicapped 
child, (Gardner), 53 (Aug) 

Brackman, Claire, Essentials of nursing, 53 
(Nov) 

Brock, Margaret Gaughan, Social work in 

the hospital organization, 54 (Sep) 
Brooks, Stewart M., Programmed introduc- 
tion to microbiology, 52 (Jan) 

Broome, W. E., Nurses technical manual 

1968-69, 47 (Dec) 
Burrell, Lenette Owens, Intensive nursing 

care, (BuneU) 47 (Dec) 
Burrell, Zeb L., Intensive nursing care, 
(Burrell), 47 (Dec) 

Cable, James Vemey, Principles of medi- 
cine, 52 (Aug) 

Caccamo, Leonard P., Resuscitation: a 
programmed course, (Kessler, Azneer), 52 
(Jan), 

Campbell Donald, A nurse's guide to 
anaesthetics, resuscitation and intensive 
care, (Norris), 53 (Nov) 
Canadian Nurses' Association, Countdown 
1968, 46 (Apr) 
IV 



Canadian Nurses' Association, Presence, 9 

(Sep) 
Carnevali, Doris L., Nursing care planning, 

(Little), 5 1 (Nov) 
Chaffee, Ellen E., Basic physiology and 

anatomy, (Greishemier), 56 (Sep) 
Chen, Philip S., Chemistry: inorganic, organ- 
ic and biological, 56 (May) 
Cherescavich, Gertrude D., A textbook for 

nursing assistants, 58 (Sep) 
Christie, A. B., Infectious diseases, 70 (Feb) 
Cowless Education Corp., How to pass 
entrance examinations for registered and 
graduate nursing schools, 5 1 (Jan) 
Community Health Nursing Faculty, Work- 
book for community health nursing prac- 
tice, 49 (Jan) 
Craddock, Denis, Obesity and its manage- 
ment, 52 (Nov) 
Crelin, Edmund S., Anatomy of the new- 
born: an atlas, 54 (Sep) 
Daniel, Gerald S., The treatment of mental 
disorders in the community, (Freeman), 
57 (May) 
Dauer, Cart C, Infectious diseases, 49 (Jun) 
Dolan, Josephine A., History of nursing, 66 

(Feb) 
Dominian, Jack, Marital breakdown, 65 

(Feb) 
Ellis, Richard W. B., Disease in infancy and 

childhood, (Mitchell), 50 (Jun) 
Ferrer, H. P. Screening for health; theory 

and practice, 58 (Sep) 
Foote, William R., Human labor & birth, 

(Oxorn), 50 (Aug) 
Freedman, Marilyn Gottehrer, Clinical nurs- 
ing workbook for practical nurses, (Han- 
nan), 50 (Jan) 
Freeman, Hugh L , The treatment of mental 
disorders in the community, (Daniel) 57 
(May) 
Frobisher, Martin et al. Microbiology in 

health and disease, 58 (Sep) 
Gardner, Leslie, The young handicapped 

child, (Bowley), 53 (Aug) 
Garrod, P., Antibiotic and chemotherapy, 

(O'Grady), 37 (Jul) 
Gillies, Dee Ann, Saunders tests for self 
evaluation of nursing competence, (Alyn), 
68 (Feb) 
Gordon, E. B., Basic psychiatry, (Sim) 56 

(May) 
Greisheimer, Esther M., Basic physiology 

and anatomy, (Chaffee), 56 (Sep) 
Gunzburg, H. C, Social competence & 
mental handicap - an introduction to 
social education, 52 (Aug) 
Hadley, Anne, The medical secretary as a 

word technician, 49 (Apr) 
Hannan, Justine, Qinical nursing workbook 
for practical nurses, (Freedman), 50 (Jan) 
Hoffman, Qaire P., Simplified nursing, 

(Lipkin, Thompson), 50 (Jan) 
Hospital for Sick Children, Toronto, Celiac 
disease recipes for parents and patients, 66 
(Feb) 
Hum, B.A.L. Storage of blood, 42 (Mar) 

Johnson, Warren R., Human sexual behavior 
and sex education: perspectives and prob- 
lems, 58 (May) 

Johnston, Dorothy F., Essentials of com- 



municable disease with nursing principles, 
38 (Jul) 

Johnston, Dorothy, F., Total patient care, 
foundations and practice, 68 (Feb) 

Kesler, Henry H., The knife is not enough, 
54 (May) 

Kessler, Edward, Resuscitation: a pro- 
grammed course, (Caccamo, Azneer), 52 
(Jan) 

Kilgour, O.F.G., An introduction to the 
physical aspects of nursing science, 57 
(Sep) 

Klug, Barbara, The process of patient teach- 
ing in nursing, 65 (Feb) 

Lipkin, Gladys B., Simplified nursing, (Hoff- 
man, Thompson), 50 (Jan) 

Little, Dolores E., Nursing care planning 
(CarnevaU), 5 1 (Nov) 

Lockerby, Florence K.. Communication for 
nurses, 49 (Jan) 

Louise, Mary, Sister The operaring room 
technician, 38 (Jul) 

Macfarland, Mary E.. History, School of 
Nursing, Toronto General Hospital, vol.2, 
1932-1967, 37 (Jul) 

Mackey, H.O., Handbook of diseases of the 
skin, 49 (Jun) 

Manfreda, Lucy, Psychiatric nursing, 48 
(Apr) 

Marlow, Dorothy R., Text book of pediatric 
nursing, 53 (Nov) 

Mercy Hospital, Pittsburgh, A manual for 
team nursing, 66 (Feb) 

Millar, Susanna, The psychology of play, 50 
(Aug) 

Mitchell, J. P.. Urology for nurses, 41 (Mar). 

Mitchell, Ross G., Disease in infancy and 
childhood, (Ellis), 50 (Jun) 

Moroney, James, Surgical principles, 
(Stock), 57 (May) 

Myles, Margaret F., Textbook for midwives, 
46 (Apr) 

Norris, Walter, A nurse's guide to anaesthet- 
ics, resuscitation and intensive care, 
(Campbell), 53 (Nov) 

O'Grady, Francis, Antibiotic and chemothe- 
rapy, (Garrod), 37 (Jul) 

Oxorn, Harry, Human labor & birth, 
(Foote), 50 (Aug) 

Owen, David, A unified health service, et al, 

69 (Feb) 

Partheymuller, Margaret T. Forces affecting 
nursing practice, (Petrowski), 59 (Sep) 

Penchansky, Roy, Health services adminis- 
tration: policy cases and the case method, 

70 (Feb) 

Perkins, John J.. Principles and methods of 

sterilization in health sciences, 55 (May) 
Petrie, Asenath, Individuality in pain and 

suffering, 49 (Jan) 
Petrowski, Dorothy D. Forces affecting 

nursing practice (Partheymuller), 59 (Sep) 
Primrose, Rosellen Bohlen, Pediatric surgery 

for nurses, (Raffensperger), 53 (Aug) 
Raffensperger, John G. Pediatric surgery 

for nurses, (Primrose). 53 (Aug) 
Saunders, Mary, Health visiting practice, 56 

(May) 
Saunders, William H.. el al. Nursing care in 

eye, ear, nose, and throat disorders, 41 

(Mar) 



Schor, Stanley S.. Fundamentals of bio- 
statistics, 50 (Aug) 

Schurr, Margaret. Leadership and the nurse: 
an introduction to the principles of 
management, 51 (Nov) 

Seager, C. P., Psychiatry for nurses, social 
workers, and occupational therapists. 56 
(May) 

Senn, Milton J. E.. Problems in child behav- 
ior and development, (Solnit), 54 (May) 

Shamsie, S. J. Adolescent psychiatry, 50 
(Jan) 

Sim, Myre, Basic psychiatry, (Gordon), 56 
(May) 

Slatt, Bernard J.. The ophthalmic assistant, 
(Stein), 49 (Jun) 

Smeltzer, C H. The interview in student 
nurse selection, 68 (Feb) 

Smith, Alice L. Microbiology and patholo- 
gy, 50 (Jun) 

Smith, Alice L. Principles of microbiology, 
52 (Nov) 

Solnit, Albert J.. Problems in child behavior 
and development, (Senn) 54 (May) 

Stein, Harold A., The ophthalmic assistant, 
(Slatt), 49 (Jun) 

Stock, Francis E,. Surgical principles, 
(Moroney) 57 (May) 

Sutherland, John D.. The psychoanalytic 
approach, 51 (Jun) 

Sutton, Audrey Latshaw, Bedside nursing 
techniques in medicine and surgery, 56 
(Sep) 

Swansburg, Russell C , Inservice education, 
59 (May) 

Thomas, James Blake, Introduction to 
human embryology, 46 (Apr) 

Thompson, Ella M.. Simplified nursing, 
(Hoffman, Lipkin), 50 (Jan) 

Thomson, William A.R.. Sex and its prob- 
lems, 4 1 (Mar) 

Ujhely, Gertrud, Determinants of the nurse- 
patient relationahip, 48 (Apr) 

Vanderpoel, Sally, The care & feeding of 
your diabetic child, 67 (Feb) 

Volk, Wesley A., Basic microbiology, 
(Wheeler), 54 (Sep) 

Weiser, Russell S.. et al. Fundamentals of 
immunology for students of medicine and 
related sciences, 51 (Oct) 

Wheeler. Margaret F.. Basic microbiology, 
(Volk), 54 (Sep) 

Williams, Sue Rodwell. Nutrition and diet 
therapy, 52 (Aug) 

Wolman, Benjamin B. The unconscious 
mind - the meaning of Freudian psycho- 
logy, 65 (Feb) 

Wooldrige, James K. et al Behavioral sci 
ence, social practice, and the nursing 
profession, 54 (May) 

Zeitz, Ann N., et al. Associate degree 
nursing: a guide to program and curricu- 
lum development, 47 (Dec) 

BOOKS 

49 (Jan). 65 (Feb), 41 (Mar), 46 (Apr), 54 
(May), 49 (Jun), 37 (Jul). 50 (Aug), 54 
(Sep), 51 (Oct), 51 (Nov). 47 (Dec). 

BOONE, Margaret I. 

Lecturer, school of nursing, Lakehead Uni- 
versity, (port), 20 (May) 



BOSSE, Marielle 

NBARN scholarship, 21 (Nov) 

BRAWLEY, Arleen 

Muriel Archibald Scholarship, 21 (Nov) 

BRIDGES, Daisy C. 

The growth and development of a profes- 
sion, 32 (Jun) 

BRUNET, Jacques 

Laval University accepts a challenge, (Ga- 
gnon), 44 (Aug) 

BRUSER, Michael 

How much bleeding? 44 (Jan) 

BUGAYONG, L. 

Bk. rev., 53 (Nov) 

BURGOYNE, Eileen 

Bk. rev., 41 (Mar) 

BURNIE, R. 

Two-year-old Michael - ill and in hospital, 
46 (Nov) 

BURWELL, Elinor 

Bk. rev., 50 (Aug) 

BURWELL. Dorothy M. 

Psychodrama, 44 (May) 

BUTLER, Ada 

RNABC bursary, 21 (Nov) 

BUTLER, Laura E. 

President, RNAO, (port), 20 (Jun) 

BUTZ Irma 

Appointed assistant director of nursing, 
Douglas Hospital, Verdun, Quebec, 22 
(Jun) 



CEGEP 

Montreal to close English language hospital 
schools of nursing, 8 (jul) 

CABELLI Anita 

CNF award, 9 (Sep) 

CAHOON. Margaret C. 

Associate professor. University of Toronto, 
(port), 23 (Apr) 

CALKIN, Joy 

Bk. rev. 67 (Feb) 

CAMILLUS, Sister 

Bk. rev., 52 (Nov) 

CAMPBELL, S. Maureen, 

Instructor, Sask. Institute of Applied Sci- 
ences, 22 (Apr) 

CANADIAN ASSOCIATION OF NEURO 
LOGICAL AND NEUROSURGICAL NURSES 

Canadian neuro nurses form association, 13 
(Sep) 

CANADIAN CONFERENCE OF 
UNIVERSITY SCHOOLS OF NURSING 

CCUSN Atlantic region assesses need for 

master's program, 10 (Jun) 
CCUSN elects executive, 7 (Jan) 
CCUSN (A) submits brief to Maritime union 

study, 15 (Oct) 



University nurses present brief to Caston- 

guay Commission, 12 (May) 
Western region of CCUSN holds annual 

meeting, 10 (May) 

CANADIAN COUNCIL OF 
HOSPITAL ACCREDITATION 

CCHA rejects CNA bid for representation, 9 
(Jun) 

CANADIAN HOSPITAL 

Attacks new postal rates, 16 (Sep) 

CANADIAN HOSPITAL ASSOCIATION 

CNA, CMA, CHA discuss hospital medical 
staff relations, 14 (Apr) 

"Design, Then Build," renowned consultant 
tells CHA, 18 (Aug) 

Metric conversion kits available from CHA, 
13 (Dec) 

"Organize resources" Minister tells CHA, 10 
(Jul) 

To study nursing education, 10 (Jul) 

Time out at the Canadian Hospital Associa- 
tion convention, 10 (Jul) 

CANADIAN MEDICAL ASSOCIATION 

CNA, CMA, CHA discuss hospital-medical 
staff relations. 14 (Apr) 

CANADIAN MENTAL HEALTH 
ASSOCIATION 

Approves volunteer services for emotionally 
disturbed children, 9 (Jul) 

CANADIAN NURSE 

CNA's journals reclassified as third class 

mail, 9 (May) 
Journals' postal problems discussed by CNA 

board, 7 (Mar) 
Postal rate increases may affect CNA 

magazines, 7 (Feb) 
Postal rates, (Lindabury), (editorial). 3 

(Feb) 
Thought and action, (Van Raalte), 25 (Mar) 

CANADIAN NURSES' ASSOCIATION 

Ad Hoc committee completes draft for 
standards tor nursing service, 7 (Jul) 

Asks government for a million dollars more, 
12 (Apr) 

Associate director to participate in WHO 
conference in New Delhi. 1 1 (Oct) 

CCHA rejects CNA bid for representation, 9 
(Jun) 

CNA executive director honored, 10 (Dec) 

CNA, CMA, CHA discuss hospital-medical 
staff relations. 14 (Apr) 

CNF to receive CNA funds for research in 
nursing service, 10 (Dec) 

Countdown 1968, Ottawa, 46 (Apr) 

Executive director predicts change in sci- 
ence of nursing not in art of nursing, 1 2 
(Dec) 

Gold chain honors nurses, 7 (Jul) 

Greek gift to CNA, 10 (Sep) 

Guide on nursing service standards to be 
published by CNA, 1 1 (Dec) 

Lobbying, (Lindabury), (editorial), 3 (Jul) 

Needed: a full-time lobbyist, (Lindabury), 
(editorial), 21 (Jul) 

New CNA bylaws approved at special meet- 
ing, 9 (Dec) 

1968-70 goals approved, 8 (Apr) 

1969 fee$ are due, 16 (Mar) 

V 



Nursing assistants are here to stay, (Kergin), 

33 (Apr) 
Provisional board to be set up for CNA 

testing service, 10 (Dec) 
Official directory, 80 (Aug) XVIII (Dec) 
Special ad hoc committee meets, 7 (Feb) 
Special CNA meeting to be held this year to 

consider bylaws, 8 (Mar) 
Testing service to locate in Ottawa, 8 (Mar) 
Thought and action, (Van Raalte), 25 (Mar) 

CANADIAN NURSES ASSOCIATION 

Works with DBS to publish statistics, 12 
(Nov) 

CANADIAN NURSES ASSOCIATION 
AD HOC COMMITTEE ON FUNCTIONS 

Report to be sent to provinces for further 

study, 9 (Dec) 
Special ad hoc committee meets, 7 (Feb) 
Special committee will report to board, 11 

(Nov) 

CANADIAN NURSES' ASSOCIATION. 
ARCHIVES 

Gift to CNA Archives, 9 (Jan) 

CANADIAN NURSES' ASSOCIATION. 
BIENNIAL CONVENTION, 1968 

Copies of speeches requested, 13 (Jan) 

CANADIAN NURSES' ASSOCIATION. 
BOARD OF DIRECTORS 

Adopts Education Committee motions, 10 

(Dec) 
Qinical nursing statement revised by CNA 

board, 1 1 (Dec) 
Orientation day for new board members, 7 
(Mar) 
CANADIAN NURSES' ASSOCIATION 
COMMITTEE ON NURSING EDUCATION 
CNA board adopts education committee 
motions, 10 (Dec) 
CANADIAN NURSES' ASSOCIATION 
CONVENTION 1970 

Biennial convention to open on a Sunday, 

12 (Dec) 
Plans underway for CNA convention, 11 
(Nov) 

CANADIAN NURSES' ASSOCIATION. 
LIBRARY 

Accession list, 54 (Jan), 70 (Feb), 43 (Mar), 

50 (Apr), 60 (May), 51 (Jun) 39 (Jul), 54 

(Aug), 60 (Sep), 51 (Oct), 54 (Nov), 49 

(Dec) 

CNA library wants theses, 12 (Oct) 

Mailing charges both ways on CNA library 

loans, 10 (Mar) 
New look in CNA Library, 1 1 (Oct) 
Resources and use of CNA library, (Parkin), 
32 (Mar) 

CANADIAN NURSES' FOUNDATION 
Announces scholarship winners, 9 (Sep) 
Board meets and appoints new officers, 15 

(Apr) 
A dollar, a dollar, follow the scholar, 

(Lindabury), 37 (Mar) 
Editorial, (Lindabury), 3 (Mar) 
Elects new board, ponders financial prob- 
lem, 12 (Mar) 
McGill student nurses contribute to CNF, 
18 (Aug) 
VI 



SRNA announces annual CNF donation, 13 

(Mar) 
Scholarship fund drops to $25,000 for 

1969, 7 (Feb) 
To receive CNA funds for research in 

nursing service, 10 (Dec) 

CANADIAN RED CROSS 

Established nursing fellowship, 15 (Jul) 
Red cross bursary offered to Ontario nurses, 
19 (Apr) 

CANADIAN WELFARE COUNCIL 

Visiting homemaker services in short supply, 
19 (Aug) 

CANCER 

Cytology screening - a program that 

works (MacLean), 40 (May) 
Lung cancer on rise in Canada, 14 (Jan) 

CARR, Mary 

Bk. rev., 56 (Sep) 

CARROLL Majorie 

Lecturer, (port), 18 (Sep) 

CARTER, Len 

Canada's rare blood rank 35 (Mar) 

CARTER, Terry Lynn 

The coagulation of Harry, 38 (Oct) 

CASHIN, Joan 

Nursing sister receives OBE, (port), 17 (Mar) 

CASTONGUAY, Therese 

Two-year versus three-year programs, (Cos- 
tello), 62 (Feb) 

CHAMBERS Sharon 

Bk. rev., 58 (Sep) 

CHAPMAN, Kate 

Honorary member SRNA, 22 (Aug) 

CHICAGO UNIVERSITY 

RN internship program starts at Chicago U., 
16 (Dec) 

CHRISTIE Mary 

Retired, 22 (Oct) 

CHRISTMAS 

Home for Christmas, (Ferrari), 25 (Dec) 

CHURCH Jean L. 

Obituary, (port), 16 (Jul) 

CLARK, Kathleen M. 

Appointed an instructor. University of 
British Columbia School of Nursing, 18 
(Sep) 

CLARKE Marilyn H. 

Bk. rev., 53 (Nov) 

CLARKE INSTITUTE OF 
PSYCHIATRY 

No salary increases offered, 8 (Aug) 

COCHRANE, Frances M. 
Bk. rev.,41 (Mar) 

COHEN, Anthea 

Nurses are not neurotic, 45 (Jun) 

COLLECTIVE BARGAINING 

Alberta nurses accept new contract, 15 
(Sep) 



Collective bargaining workshops held across 
Manitoba, 15 (Mar) 

Contracts signed by Saskatchewan Nurses, 
20 (Nov) 

Hamilton nurse educators return to work, 
14 (May) 

Harder bargaining ahead for Canadian 
Nurses, 18 (Jun) 

Hospital nurses in NB submit mass resigna- 
tion, 8 (Aug) 

Hospital personnel relations bureau set up, 
18 (Apr) 

Montreal nurses sign contract with Queen 
Elizabeth Hospital. 14 (Feb) 

NBARN organizes for collective bargaining, 
13 (Jan) 

New Brunswick nurses sign new contract, 14 
(Dec) 

New Brunswick nurses to be granted collec- 
tive bargaining rights, 15 (Mar) 

New Brunswick nurses withdraw resigna- 
tions, 10 (Sep) 

No salary increases offered, 8 (Aug) 

Nurse educators go on strike, 7 (Apr) 

Nurses negotiations with NBHA deadlocked, 
8 (Jul) 

Ontario supreme court to settle terms of 
nurses' contract, 14 (Sep) 

Professional institute is bargaining agent for 
federal nurses, 12 (Apr) 

Public health nurses return to work, 13 (Jul) 

Strike of 18 nurse* educators, (Lindabury), 
(editorial), 3 (Apr) 

UNM hold second annual meeting, 12 (Jan) 

See also Labour unions 

COLLEGE OF NURSES 

College of nurses to close waiver clause, 14 
(Sep) 
COLONEL, Gayle 

RNABC bursary, 21 (Nov) 

COMMISSION ON RELATIONS BETWEEN 
UNIVERSITIES AND (GOVERNMENT 

CNA asks government for a million dollars 
more, 12 (Apr) 

COMMUNITY SERVICES 

Family health service: the PHN and the GP 
(Jones, Bondy), 38 (Sep) 

COLPITTS, H.G.M. 

Bk. rev., 37 (Jul) 

CONFERENCES AND INSTITUTES 

EC nurses begin two workshops, 16 (Jan) . 

CNA, CMA, CHA discuss hospital-medicall 
staff relations, 14 (Apr) 

Collective bargaining workshops held across 
Manitoba, 15 (Mar) 

Conference held for dialysis nurses, 15 
(Dec) 

Curriculum conferences held in Vancouver 
and Victoria, 13 (Mar) 

Family physicians meeting sees debut of 
medical convention T.V., 1 7 (Dec) 

Health manpower conference to be held in 
Ottawa, 9 (Sep) 

NBARN sponsors inservice education work- 
shop, 15 (Apr) 

NLN conference to consider health in com- 
munity, 15 (Apr) 

Operating room nurses meet, 1 7 (Dec) 



Pembroke hospital sponsors team nursing 

workshop, 14 (Jan) 
RNAO holds regional conferences on audio 

visual aids. 9 (Jan) 
Summer workshop for nurse-teachers, 15 

(Sep) 
Two workshops at UWO, 20 (Aug) 
Workshops on test construction to be held 

in London, 16 (Mar) 

COOK, K.L. 

Bk. rev. 38 (Jul) 

COOME Barbara 

Rooming-in brings family together, 47 (Jun) 

COOPER, Carol Ann 

Recipient of the Margaret MacLaren bursa- 
ry, 1 1 (Oct) 

COSTELLO, C. G. 

It's depressing! 43 (Sep) ^ 

Two-year versus three-year programs, (Cas- 
tonguay), 62 (Feb) 

CRAGG, Catherine E. 

The child with leukemia, 30 (Oct) 

CRAWFORD, John N 

Retirement as deputy minister of National 
Health, 18 (Dec) 

CROTIN, Gloria G. 

Medicolegal problems can arise in the coron- 
ary care unit, 37 (Apr) 

Nursing supervisors' perception of their 
functions and activities, (abst), 48 (Jun) 

CRYDERMAN, Eileen 
Retired, (port), 18 (Sep) 

CUNNINGHAM, Helen 

Director of nursing services, Ottawa Civic 
Hospital, (port), 23 (Apr) 

CUNNINGS, Bente 

Interim executive director of MARN, (port), 
20 (Dec) 

CUTHBERT, Ruby 

Bk. rev., 59 (Sep) 



D 



DANIELS, Leota 

Bk rev., 50 (Jan) 

DATES 

20 (Jan), 25 (Feb), 20 (Mar), 24 (Apr), 22 
(May), 24 (Jun), 18 (Jul), 23 (Aug), 20 
(Sep), 24 (Oct), 22 (Nov), 21 (Dec) 

DAVELUY; DanieUe 

Peruvian adventure, 36 (Sep) 

DAVIS, Beatrice 

Director of Victoria Hospital, School of 
nursing, London, Ontario, (port), 20 (Dec) 

DAVIS, Beth 

Bk. rev., 50 (aug) 

DAVIS, Theresa M. A. 

CNF award, 9 (Sep) 

DAWES, J. M. 

Bk. rev., 47 (Dec) 



DAY NURSERIES 

New services help patients and staff, (Beau- 
dry-Johnson), 39 (Mar) 

DECHENE, Jean-Paul 

Bk rev., 52 (Jan) 

DE GARZON, Elvia C. 

Nursing in Colombia, (Restrepo), 37 (Jun) 

DELAHANTY, M. V. 

Staff-hne conflict in hospitals, 35 (Nov) 

DEPT. OF NATIONAL HEALTH 
AND WELFARE 

Dr. Lossing retires, 22 (Oct) 

Health & welfare department marks 50th 

anniversary, 21 (Apr) 
Retirement of Dr. John N. Crawford, 18 

(Dec) 
Three nurses appointed to federal task 

forces, 8 (Apr) 

DIABETES 

Insulin injection - a new technique, (St. 
James), 32 (Jul) 

DIAGNOSIS, LABORATORY 

Clinical laboratory procedures, (Watson, 
Neufeld),41 (Feb) 

DICK, Dorothy 

Association's aims too remote says MARN 
president, 8 (Aug) 

DICXER, K 

Safe care for mother and baby, 31 (Dec) 

DICKINSON, Grant 

Male student wins recruitment poster con- 
test, 14 (Jul) 

DINEEN, Donna 

Bk. rev., 50 (Jan) 

DION, Nicole 

Appointed executive coordinator, United 
Nurses of Montreal, (port), 17 (Sep) 

DIPLOMA PROGRAMS 

See Education 

DISASTERS AND EMERGENCIES 

Emergency hospital institute displays in- 
stant hospital, 12 (Jul) 

"Good Samaritan" act passed by Alberta 
legislature, 15 (Oct) 

DOMINION BUREAU OF STATISTICS 

CNA works with DBS to publish statistics, 
12 (Nov) 

DOMKE,Caroline 

Instructor, school of nursing. University of 
B.C., 20 (May) 

DOYON, Jacques 

Medical photography - a century of prog- 
ress, 40 (Jun) 

DRUGS 

Aspirin may cause ulcers, 13 (Jan) 

Drug adverse reaction program - and the 

nurse's role, (Napke), 40 (Dec) 
Drug prices drop, 1 7 (Dec) 
Committee to investigate nonmedical use of 

drugs, 19 (Oct) 



Medication errors can be prevented, (Tho- 
mas), 50 (May) 

DUMAS, Edna 

Registrar of SRNA, 18 (Sep) 

DU MOUCHEL, Nicole 

Awarded the Warner-Chilcott scholarship, 
(port), 19 (Jan) 

DUTRISAC, Claire 

Mind your own business, 46 (Aug) 

DUVILLARD, Marjorie 

Appointed deputy executive director of the 
ICN, (port), 16 (Jul) 



FADES, Robert W. 

Elected first president of the Association of 
Operating Room Technicians, (port), 12 
(Oct) 

EARLE, Eleanor R 

Retired as supervisor public health nursing, 
20 (Dec) 

EARLE, Nora 

Member of the Royal Society of Health, 22 
(Oct) 

ECONOMICS, NURSING 

And now your income tax . . ., (Mallett), 34 

(Apr) 
CNA works with DBS to publish statistics, 

12 (Nov) 
Breakthrough for nurses at St. Joseph's 

Hospital Guelph, 12 (Oct) 
CNA sets 1970 salary goals: $7,200 for 

diploma nurses, $8,460 for university 

grads, 7 (Mar) 
Federal government nurses get more pay, 11 

(Oct) 
Nurses' associations granted salaries that 

exceed those set by OHSC, 16 (Mar) 
No salary increases offered, 8 (Aug) 
OHSC raises bonus rates for service person- 
nel; teachers' bonuses remain same, 9 

(Jan) 
PEl nurses granted salary increases, 14 (Mar) 
RNAO recommends $7,000 as minimum 

salary for RN, 14 (Jun) 

EDUCATION 

Board approves nursing education motions, 

10 (Mar) 
CEGEP system explained at ANPQ general 

meeting, 9 (Jan) 
CHA to study nursing education, 10 (Jul) 
Charge made for study tours to UK, 21 

(Apr) 
Correlates of approval and disapproval re- 
ceived by students at selected schools of 

nursing, (Hayward), (abst), 52 (Sep) 
Commuting students study en route, 12 

(May) 
Community college in Ontario to start 

nursing program 14 (Mar) 
Community colleges and nursing education 

in Ontario, (Quittenton), (abst). 46 (Jan) 
Curriculum conferences held in Vancouver 

and Victoria, 13 (Mar) 
A dollar, a dollar, follow the scholar, 

(Lindabury). 37 (Mar) 

VII 



Effectiveness of clinical instructors as per- 
ceived by nursing students, (Joseph), 
(abst), 44 (Dec) 
An exploratory study of the professienal- 
ization of Registered Nurses in Ontario . . . 
(Kergin), (abst),52 (Sep) 
First nurses graduate from Memorial Univer- 
sity, 8 (Jul) 
Inservice for teachers, too? (Post), 29 (Sep) 
Laval University accepts a challenge, 

(Brunei, Gagnon), 44 (Aug) 
McGill to offer master of nursing program, 

1 1 (Oct) 
Message from the executive director, 

(Mussallem), 3 (May) 
Montreal to close English language hospital 

schools of nursing, 8 (Jul) 
More nursing schools move within frame- 
work . . . education, 9 (May) 
NB nurses discuss trends in diploma pro- 
grams, 16 (Dec) 
NBARN sponsors inservice education work- 
shop, 15 (Apr) 
Nurses and educational change, (Kergin), 28 

(Dec) 
Nurses discuss future of nursing education, 

10 (May) 
Nursing home administration course starts 

in Ontario, 14 (Dec) 
On the delegation of responsibility, (Nance), 

29 (Nov) 
RN internship program starts at Chicago U., 

16 (Dec) 
RNANS considers principles of curriculum 

building, 8 (jul) 
Ryerson Institute offers short courses for 

RNA, 20 (Nov) 
Senior civil servant misquoted in newspaper, 

14 (Dec) 
Several reasons for drop in enrollment says 

RNANS, 9 (Feb) 
Student enrollment increases in Nova 

Scotia, 20 (Nov) 
A study of the needs of graduates from two 
year diploma nursing programmes in Cana- 
da, (MacLeod), (GiU), (abst), 44 (Dec) 
Summer workshop for nurse-teachers, 15 

(Sep) 
Student observation at postmortem exami- 
nations, (Lindabury), 57 (Feb) 
A study of the attitudes of nurse faculty 
members in a selected Canadian province 
. . .(Richard), (abst), 53 (May) 
Too little, for too long, from federal govern- 
ment, (Good), 29 (May) 
Trends reversing in nursing education, 13 

(Sep) 
Two-year program discussed at RNANS 

annual meeting, 19 (Aug) 
Two-year versus three-year programs, 

(Costello, Castonguay), 62 (Feb) 
U of T school of nursing celebrates 50th 

anniversary, 13 (Dec) 
UBC celebrates golden jubilee, 8 (Mar) 
University nurses present brief to Caston- 
guay Commission, 12 (May) 

EDUCATION, CONTINUING 

Aging and learning, (Angus), 41 (Nov) 
Board approves revised continuing educa- 
tion statement, 8 (Mar) 
VIII 



Extension courses continue to be popular, 
14 (May) 

The prediction of college level academic 
achievement in adult extension students, 
(abst), (Flaherty), 49 (Aug) 

EDUCATIONAL MEASUREMENT 

Two-year versus three-year programs (Cos- 
tello, Castonguay), 62 (Feb) 

EQUIPMENT 

"Fasten seat belt, please", 16 (Jan) 
A new design for stryker turning frame 
covers, (Young), 45 (Jan) 

EUTHENASIA 

Royal College of nursing against voluntary 
euthanasia, 15 (Jul) 

EVANS, Helen 

Bk.rev., 53 (Aug) 

EVANS, MoUy 

Bk. rev., 46 (Apr) 



FACULTY 

A study of the attitudes of nurse faculty 
members in a selected Canadian province 
. . . (Richard), (abst), 53 (May) 

FAIRLEY, Grace M. 

Deceased, 18 (May) 

FAULKNER, Carole J. Aalto 

Lecturer, school of nursing, Lakehead Uni- 
versity, (port), 20 (May) 

FEES 

NBARN holds meeting to vote on fee 

increase, 20 (Nov) 
1969 feeSaredue, 16 (Mar) 

FELICITAS, Mary, Sister 

Gold chain honors nurses, 7 (Jul) 
Whoo-Fur pinned down at last, 9 (Jun) 

FELIX, M. A. 

Bk. rev., 58 (Sep) 

FENWICK, Ethel Gordon 

The growth and development of a profes- 
sion by Daisy C. Bridge, (port), 32 (Jun) 

FERRARI, H.E 

Home for Christmas, 25 (Dec) 

FILMS 

See Audio-visual Aids 

FILM REVIEWS 

52 (Jan), 39 (Jul), 53 (Nov), (Dec) 
FLAHERTY, M. Josephine 

Bkrev., 51 (Jan),68 (Feb) 

Granted the degree of Doctor of Philoso- 
phy, 17 (Mar) 

The prediction of college level academic 
achievement in adult extension students, 
(abst), 49 (Aug) 

President-elect RNAO, (port), 20 (Jun) 

FLEMING, Florence M. 

Retired December 31, 1968, 21 (Feb) 

FLEURY, Agnes 

Director of nursing service, Manitoba Re- 
habilitation Hospital, (port), 20 (Dec) 



FOURNIER, Valerie 

Bk.rev., 65 (Feb) 

Do your own thing in Montreal. (Lcgault) 
31 (May) 

FORREST, Jean W. 

Appointed assistant professor of the School 
of Nursing, The University of Western 
Ontario, (port), 22 (Jun) 

FRANCIS, M. 

Bk. rev., 52 (Nov) 

FRIESEN, Gordon 

"Design, Then Build," renowned consultant 
tells CHA, 18 (Aug) 

FRYE, C 

The nurse is a specialist in the artificial 
kidney unit, 33 (Dec) 



GAGNON, Claire 

Laval University accepts a challenge, (Bru- 
nei), 44 (Aug) 

GAGNON, Madeleine 

Medical illustration - an art and a science, 
42 (Jun) 

GARDNER, Robin 

Bk. rev., 56 (Sep) 

GERIATRICS 

Aging and learning, (Agnus), 41 (Nov) 

A guide for the public health nurse to assist 
elderly patients . . . (Wilson), (abst), 50 
(Sep) 

GIRARD, Alice 

ICN president receives order of Canada, 19 
(Jan) 

GILL, Catherine, Sister 

A study of the needs of graduates from two 
year diploma nursing programmes in Cana- 
da, (abs), 44 (Dec) 

GITTINS, Laveena Anne 

Coordinator, school of diploma nursing 
SIAAS, (port), 24 (Feb) 

GLASS, Helen P. 

Awarded the Dr. Katherine E. MacLaggan 
Fellowship, 9 (Sep) 

GODARD, Jean 

Bk.rev., 57 (Sep) 

GOLDBERG, B. June 

Bk. rev., 51 (Oct) 

GOOD, Shirley R. 

Appointed the first director of school of 
nursing at the University of Calgary, 17 
(Sep) 

CCUSN Atlantic region assesses need for 
master's program, 10 (Jun) 

CNA asks government for a million dollars^ 
more, 12 (Apr) 

Too little, for too long, from federal govern- 
ment, 29 (May) 

GORDON, Ethel M. 

Retired, (port), 23 (Apr) 



GORRILL.GIennaM. 

Joins leaching statT of Red Deer Junior 
College, (port). 18 (Jan) 

GRACE GENERAL HOSPITAL. ST. JOHN'S 

"Miles lor books" answer to shortage, 12 
(Oct) 

GRAHAM. Loral 

Countdown to congress, 26 (Jan) 

Resigns as assistant editor, (port). 17 (Mar) 

GRANT. Dorothy Metic 

Lady Mary Wortley Montagu - eighteenth 
century crusader, 34 (Jul) 

GRANT. Kathryn 

The Countess Mountbatten Bursary for 
students, 11 (Oct) 

GRIBBEN. Anne 

Director of employment relations for the 
RNAO. (port), 18 (May) 

GUNN.Jean 

The growth and development of a profes- 
sion by Daisy C. Bridges, (port), 32 (Jun) 

GUPTA. Anna 

Bk. rev., 54 (May) 

H 

HACKER, Carlotta L. 

The bluebirds who went over, 31 (Nov) 

A new category of health worker for Cana- 
da? 38 (Jan) 
Private duty - private choice, 25 (Jul) 

HACON, W. S 

Senior civil servant misquoted in new^aper, 
14 (Dec) 

HARRIS, K. Anne 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

HARRY, Jean S. 

Honorary member SRNA, 22 (Aug) 

HAYWARD, Margaret 

Correlates of approval and disapproval re- 
ceived by students at selected schools of 
nursing, (abst), 52 (Sep) 

HAZLEWOOD. Barbara 

Bk. rev., 54 (Sep) 

HEALTH 

Housing affects health, 16 (Jan) 

HEALTH MANPOWER 

Health care fragmented labor leader tells 
assembly, 1 1 (Nov) 

Health manpower conference to be held in 
Ottawa, 9 (Sep) 

A new category of health worker for Cana- 
da? (Hacker), 38 (Jan) 

Physicians' assistant, (Lindabury), (editori- 
al), 3 (Jan) 
HEART 

Advances in surgery for coronary artery 
disease, (Trimble). 32 (Jan) 

Medicolegal problems can arise in the coro- 
nary care unit. (Crotin), 37 (Apr) 

Nursing the patient after heart surgery, 
(Wass), 35 (Jan) 



The value of revascularization surgery, 
(Vineberg), 28 (Jan) 

HELLENIC NURSES' ASSOCIATION 

Greek gift to CNA, 10 (Sep) 

HEMMING. Isabel 

The Countess Mountbatten Bursary for 
students. 1 1 (Oct) 

HEMODIALYSIS 

Hemodialysis in the home, (Wood), 42 

(Apr) 
The nurse is a specialist in the artificial 

kidney unit, (Frye), 33 (Dec) 

HENDERSON. Virginia 

Library display at ICN congress, 10 (Jun) 

HERD. Agnes 

Bk. rev., 48 (Apr) 

HICKNELL. Marjorie 

Assistant director of nursing, Oshawa Gene- 
ral Hospital, Ontario, (port), 18 (Jan) 

HILL. E.J. M. 

The minis have it, 44 (Nov) 

HOME CARE 

Visiting homemaker services in short supply, 
19 (Aug) 

HORN, Ethel 

Study tour in England and Scotland, 22 
(Jun) 

HORTON, Carol 

Margaret Sinn Fund bursary, 21 (Nov) 

HOSPITAL FOR SICK CHILDREN, TORONTO 

Collecting urine specimens from children, 
(Pask), 35(Oct) 

HOSPITAL NURSING SERVICE 

see Nursing service 

HOSPITALS 

Mind your own business, (Dutrisac), 46 

(Aug) 
New services help patients and staff, 

(Beaudry-Johnson), 39 (Mar) 

HOSPITALS - ADMINISTRATION 

Hospital personnel relations bureau set up, 
18 (Apr) 

Nurses for nursing (Pahner), 36 (May) 

Staff-line conflict in hospitals, (Delahanty), 
35 (Nov) 

Work progressing for standardized termi- 
nology, 16 (Feb) 

HOSPITALS - PLANNING 
AND CONSTRUCTION 

"Design, Then Build" renowned consultant 

tells CHA, 18 (Aug) 
Hospital design is a nursing affair, (Wylie), 

42 (Oct) 
How to prolong a ho^ital's lifespan, 

(Zeidler), 39 (Oct) 

HOWARD, Frances M. 

Bk. rev., 70 (Feb), 54 (May), 51 (Oct) 

CNF award, 9 (Sep) 

Left staff of the Canadian Nurses' Associa- 
tion, (port), 17 (Sep) 

Recipient of the Margaret MacLaren bursa- 
ry, 1 1 (Oct) 



Team work: the way to play the game, 29 
(Aug) 

HUFFMAN, Verna 

Nurse included in Canadian delegation to 
WHO assembly, 13 (Nov) 

HUMAN RELATIONS 

An approach to the phases of niu'se-patient 
relationships (Wallington), (abst), 50 (Sep) 

Effects of interpersonal difference, social 
distance, and social environment on the 
relationship between professionals and 
their clientele, (MacKay), (abst), 45 (Dec) 

An exploratory study of the relationship 
between physical and social-psychological 
distance and nurse-patient verbal inter- 
action, (Tissington), (abst), 44 (Dec) 

Helping the patient face reality, (Arnold), 
41 (Sep) 

The nurse and the sociopathic personality, 
(Marcus), 49 (Oct) 

HUNTER, Brenda 

The Countess Mountbatten Bursary for 
students, 1 1 (Oct) 

HUNTER, Theresa 

The Countess Mountbatten Bursary for 
students, 1 1 (Oct) 

HURLEY. Elizabeth F., Sister 

Director, nursing service, St. Vincent's Hos- 
pital, Vancouver, 21 (Feb), port, 22 (Oct) 

HUSTON, M. J. 

Bk. rev., 37 (Jul) 

HYPERBARIC OXYGEN 

Hyperbaric oxygen units - high pressure 
nursing, (ZUm), 37 (Feb) 

HYLTON, Lynsia 

Bk. rev., 59 (May) 



IDEA EXCHANGE 

44 (Jan), 46 (Sep) 

IGNACIO, Corazon 

Inservice education coordinator, St. Eliza- 
beth Hospital in North Sydney, N.S., 23 
(Apr) 

IMAI, Hisako Rose 

CNF award, 9 (Sep) 

IMMUNIZATION 

First licence granted for Rubella vaccine, 20 

(Aug) 
Lady Mary Wortley Montagu - eighteenth 

century crusader, (Grant), 34 (Jul) 

IN A CAPSULE 

24 (Jan), 30 (Feb), 22 (Mar), 30 (Apr), 25 
(May), 28 (Jun), 19 (Jul), 26 (Aug), 26 
(Sep), 26 (Oct), 26 (Nov), 23 (Dec) 
INDEXES 

see Abstracting and indexing 

INDIANS AND ESKIMOS 

Health care for remote-area Indians, 1 1 (Jul) 

INFECTION CONTROL 

Infections in the hospital, (Pequegnat), 27 
(Mar) 

IX 



INFECTIONS 

Insulin injection - a new technique, (St. 
James), 32 (Jul) 

INSERVICE EDUCATION 

see Education 

INTENSIVE CARE UNITS 

Medicolegal problems can arise in the coro- 
nary care unit, (Crotin), 37 (Apr) 

INTERNATIONAL COUNCIL OF NURSES 

Election results, 19 (Aug) 
The growth and development of a profes- 
sion, (Bridges), 32 (Jun) 
Meet the ICN staff, 10 (Jun) 
New ICN executive, 21 (Aug) 
President receives Order of Canada, 19 (Jan) 
3M donates fellowship, 10 (Aug) 

INTERNATIONAL COUNCIL OF NURSES. 
CONGRESS 1%9 

ANPQ donates $50,000 to ICN congress, 1 2 
(Mar) 

Alberta and British Columbia announce 
contributions to ICN, 13 (Mar) 

Continuity of patient care discussed by ICN 
panelists, 14 (Aug) 

Countdown to congress, (Graham), 26 (Jan) 

Daily registration fee for ICN congress 
reduced, 8 (Apr) 

Do your own thing in Montreal, (Foumier, 
Legault), 3 1 (May) 

ICN Congress breaks all registration records, 
7 (Aug) 

ICN Congress registration continues to lag, 
12 (Jan) 

ICN Congress report, 30 (Aug) 

ICN election results, 19 (Aug) 

ICN interest session debates role of re- 
habilitation nurse, 1 7 (Aug) 

ICN interest session speakers examine nurs- 
ing legislation, 16 (Aug) 

ICN nominations announced, 18 (Apr) 

ICN receives $8,000 from AARN, 9 (Jun) 

ICN registration triples, 13 (Mar) 

International forum in Montreal, (Quinn), 
(editorial), 3 1 (Jun) 

Internationally-known nurses debate prac- 
tice of nursing at ICN interest session, 14 
(Aug) 

Lester Pearson cancels ICN commitment, 9 
(May) 

Library display at ICN congress, 10 (Jun) 

Library issues discussed by ICN paneUsts, 14 
(Aug) 

Minister announces national nurse week, 15 
(Jun) 

Montreal as I see it . . ., 35 (May) 

Newfoundland donates $1,840 to CNA for 
ICN costs, 9 (May) 

Nurses' Christian Fellowship at ICN, 16 
9 (May) 

Nurses reluctant to write ICN delegates told, 
18 (Aug) 

Parlez-vous fran9ais? Espanol? Deutsche? , 
25 (May) 

Provincial associations help with ICN con- 
gress, 14 (Apr) 

RNABC contributions to ICN reach $8,400, 
(May) 

RNABC donates $5,000 to CNA for ICN 
costs, 14 (Jan) 



RNAO plans programs for ICN visitors, 14 

(Apr) 
Registration picks up as cut off date nears, 9 

(Feb) 
Some thoroughly modem millies, 10 (May) 
Special sessions for ICN congress registrants, 

13 (Mar) 
Students want voice at ICN begin to speak 

out on issues, 7 (Aug) 
Too much treatment a danger warns ICN 

psychiatry panelist, 16 (Aug) 
Two students selected to attend ICN Con- 
gress, 15 (Apr) 
UR a PR for ICN, says PRO, 9 (Feb) 
Well-known speakers to address ICN, 7 (Jan) 
White Sister donates $30,000 scholarship, 

10 (Aug) 
Whoo-Fur pinned down at last, 9 (Jun) 
Whoo-fur-lCN's furry mascot, 9 (May) 

IRENE, Mary, Sister 
Bk. rev., 65 (Feb) 

IRWIN, Margaret E. V. 

Librarian, Victoria Hospital School of Nurs- 
ing, (port), 18 (Jan) 



JACKSON, Robert 

Bk. rev., 49 (Jun) 

JAMIESON, Janie E. 

Keep the private duty directories running, 
45 (Jan) 

JENNY, Jean 

Bk. rev., 54 (May) 

JONES, PhylUs E. 
Bk rev., 49 (Jan) 

Family health service: the PHN and the GP, 
(Bondy), 38 (Sep) 

JOHNSON, Mary Elizabeth 

Assistant professor, school of nursing. 
Queen's University, 20 (May) 

JOSEPH, Mary 

Effectiveness of clinical instructors as per- 
ceived by nursing students, (abst), 44 
(Dec) 



KAMP, Dorothy 

Director of nursing service, General Hospital 
in Windsor, (port), 18 (Sep) 

KEELER, Hazel B. 

Retiring as director of the school of nursing, 
U. of Saskatchewan, (port), 22 (Aug) 

KERGIN, Dorothy J. 

A dollar a dollar follow the scholar, 37 
(Mar) 

An exploratory study of the professionaliza- 
tion of Registered Nurses in Ontario and 
the implications for the support of change 
in basic nursing educational programs, 
(abst) 52 (Sep) 

KERGIN, D 

Nurses and educational change, 28 (Dec) 
Nursing assistants are here to stay, 33 (Apr) 

KERNEN, H. 

Bk rev., 52 (Jan) 



KERR, Jean 

Gift to CNA Archives, 9 (Jan) 

KERR, Marion Estelle 

Recipient of the Margaret MacLaren Bursa- 
ry, 1 1 (Oct) 

KEYES, Mary Elizabeth 

Honorary member SRNA, 22 (Aug) 

KIDNEYS 

Conference held for dialysis nurses, 15 

(Dec) 
Hemodialysis in the home, (Wood), 42 

(Apr) 

KIKUCHI, June Fumiko 

CNF award, 9 (Sep) 

KIRKLAND, Lois 

Bk. rev., 57 (May) 

KLIEWER, Pauline Annette 

Guilt: an operationally defined concept, 
(abst), 50 (Sep) 

KLINGMAN, Joyce M. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

KOTASKA, Janelyn G. 
Bk. rev., 51 (Oct) 

KOTLARSKY, Carol 

Became editorial assistant, (port), 17 (Mar) 

KOWALCHUK, B. 

Making a comeback, 29 (Oct) 

KUTSCHKE, Myrtle A. 
Bk rev., 49 (Jan) 



LABOR UNIONS 

Management nurses organize in New Bruns- 
wick, 17 (Oct) 
Nurse educators go on strike, 7 (Apr) 
UNM elects new officers, 14 (Feb) 
See also Collective bargaining 

LACROIX, Eljane 

Montreal as I see it . . ., 35 (May) 

LANDON, Annetta L. 

Retired, (port), 22 (Apr) 

LANE, Marlene A. 

The relationship between the physical ad- 
justment of children to diabetes . . ., 
(abst), 46 (Jan) 

_LAVAL UNIVERSITY 

Laval University accepts a challenge, (Bru- 
net, Gagnon), 44 (Aug) 

LAWFORD, Valda 

Bk. rev., 54 (May) 

LAWLEY, Kathleen 

RNABC bursary, 21 (Nov) 

LAYCOCK, S. R. 

Bk. rev., 4 1 (Mar) 

LEASK, Janice 

The Countess Mountbatten Bursary for stu- 
dents, 1 1 (Oct) 



LEASK, Jean C. 

Recipient of the R.D. Defries Award, (port), 
16 (Jul) 

LECKIE, Nessa 

Director of nursing Douglas Hospital, Ver- 
dun, (port), 22 (Oct) 

LEE, Margaret N. 
Bk. rev.. 52 (Jan) 

LEGAULT, Agathe 

Do your own thing in Montreal, (Foumier), 

31 (May) 

LEGISLATION 

AARN holds district ralhes to study bill 
119, 15 (Nov) 

Fear of malpractice suits reaches Canadian 
nurses, 1 2 (Jul) 

"Good Samaritan" act passed by Alberta 
legislature, 15 (Oct) 

ICN interest session speakers examine nurs- 
ing legislation, 16 (Aug) 

A look at ana's legislative program, (Linda- 
bury), 22 (July) 

Medicolegal problems can arise in the coro- 
nary care unit, (Crotin), 37 (Apr) 

Mind your own business, (Dutrisac), 46 
(Aug) 

Professional liability insurance available to 
ANPQ members, 12 (Apr) 

■'Write it down" OHA panel suggests, 13 
ff)ec) 

LETTERS 

4 (Jan), 4 (Feb), 4 (Mar), 4 (Apr), 4 (May), 
4 (Jun), 4 (Jul), 4 (Aug), 4 (Sep), 4 (Oct), 
4 (Nov), 4 (Dec) 

LEUKEMIA 

The child with leukemia, (Cragg), 30 (Oct) 

LEVESQUE, Virginia D. 

Appointed director of nursing at Oromocto 
Public Hospital, (port), 18 (Sep) 

LEWIS, Heather 

Recipient of the Margaret MacLaren Bursa- 
ry, 1 1 (Oct) 
UBRARIES 

Library issues discussed by ICN panelists, 14 

(Aug) 
Library display at ICN congress, 10 (Jun) 
"Miles for books" answer to shortage, 12 

(Oct) 
Resources and use of CNA library, (Parkin), 

32 (Mar) 

LICENSURE 

Needed: a full-time lobbyist, (Lindabury), 
(editorial), 21 (Jul) 

LIGUORI, M. Sister 

A "two-way street, 30 (Mar) 

LINDABURY, Virginia A. 

C)anadian Nurses' Foundation, (editorial), 3 

(Mar) 
A dollar, a dollar, follow the scholar, 37 

(Mar) 
International Council of Nurses. Congress 

1969, (editorial), 3 (Aug) 
Lobbying, (editorial), 3 (Jul) 
A look at ana's legislative program 22 (Jul) 



Needed: a full-time lobbyist, (editorial), 21 
(Jul) 

Physicians' assistant, (editorial), 3 (Jan) 

Poison ivy, (editorial), 3 (Sep) 

Postal rates, (editorial), 3 (Feb) 

Strike of 18 nurse educators, (editorial), 3 
(Apr) 

Student observation at postmortem exami- 
nations, 57 (Feb) 

Your image (editorial), 3 (Oct) 

LOBBYING 

Lobbying, (Lindabury), (editorial), 3 (Jul) 
A look at ANA's legislative program, (Linda- 
bury), 22 (Jul) 
Needed: a full-time lobbyist, (Lindabury), 
(editorial), 22 (Jul) 

LOGAN, M. Kathleen 

Assistant director of nursing, St. Vincent's 
Hospital, Vancouver, 21 (Feb) 

LONERGAN, Margaret M. 

Nursing consultant. .Mental Health Branch, 
B.C. Department of Health Services, 
(port), 18 (May) 

LOSSING, E. H. 

Retires, 22 (Oct) 

LUBIN, Bernard 
Bk. rev., 65 (Feb) 

LUSSIER, Rita J. M. 
CNF award, 9 (Sep) 

LYSS, Liny E. 

Assistant professor, school of musing. Lake- 
head University, (port), 20 (May) 



M 



MACAULAY, Mary 

Bk. rev., 52 (Aug) 

MacDONALD, E. M 

Parents participate in care of the hospitaliz- 
ed chUd, 37 (Dec) 

MACDONALD, Marcella 
Bk. rev.,41 (Mar) 

MACDONALD, Sandra Arleigh Shanks 

Lecturer, U. of Alberta, (port), 22 (Feb) 

McELROY, PhyUis E. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

McEWAN, Elaine Audrey 

Lecturer, school of nursing, Univ. of New 

Brunswick, (port), 22 (Apr) 
Women's feelings about the figure change in 

pregnancy, (abst), 53 (May) 

McGILL UNIVERSITY 

McGill student nurses contribute to CNF, 

18 (Aug) 
McGill to offer master of nursing program, 

1 1 (Oct) 
McGill University project in Baffln Zone, 16 

(Dec) 

McKILLOP, Madge 

President of the Saskatchewan Registered 
Nurses' Association, (port), 18 (Dec) 



McILRATH, Ruth E. 

Director of nursing, Shaughnessey Veterans 
Hospital, Vancouver, (port), 21 (Feb) 

McIVER, Sheila 

Good Citizenship award in Victoria, B.C., 
18 (Sep) 

McIVER, Vera 

Communal dining, 45 (Apr) 

MACK, Hope 

RNANS Honorary membership, 22 (Aug) 

MacKAY, Ruth C 

Effects of interpersonal difference, social 
distance, and social environment on the 
relationship between professionals and 
their clientele, (abst), 45 (Dec) 

MACKENZIE, Florence I. 

A study of the relationship between the 
information about the patient as a per- 
son . . ., (MacKenzie), (abst), 47 (Jan) 

MACKIE. Jean E. 

Director, Algoma Regional School of Nurs- 
ing, Sault Ste. Marie, (port), 24 (Feb) 

MACKINNON, Alice R. 

Professor, U. of Alberta, (port), 22 (Feb) 

McLEAN, Margaret 

Three nurses appointed to federal task 
forces, 8 (Apr) 

MacLEAN, Margaret A. 

Cytology screening - a program that 
works, 40 (May) 

MacLENNAN, E. A. Electa 

RNANS, Honorary membership, 22 (Aug) 

MacLEOD, Ella 

A study of the needs of graduates from two 
year diploma nursing programmes in Cana- 
da, (abst), 44 (Dec) 

McMASTER UNIVERSITY. 
SCHOOL OF NURSING 

McMaster student nurses request financial 
aid, 19 (Aug) 

MacMILLAN, Irene 

Bk. rev., 52 (Aug) 

MacLEOD. Thelma 

Bk. rev., 48 (Apr) 

McSHEFFERY, Mary 

Muriel Archibald Scholarship, 21 (Nov) 

McWILLIAM, Carol Lynn 
Bk. rev., 46 (Apr) 

Clinical instructor. New Brunswick, 22 
(Feb) 

MADELEINE, Sister 
Bk. rev., 66 (Feb) 

MALLETT, Frederick S. 

And now your income tax . . ., 34 (Apr) 

MANITOBA ASSOCIATION OF 
REGISTERED NURSES 

Announced three appointments to its pro- 
fessional staff, 20 (Dec) 

XI 



Association's aims too remote says MARN 

president, 8 (Aug) 
Co-sponsors program for inactive nunes, 16 

(Jan) 
MARN awards bursaries, 16 (Dec) 
Official opening of MARN headquarters. 10 

(Mar) 
Surveys staffing patterns, 1 2 (May) 

MANNARD, Lynne 

The Countess Mountbatten Bursary for 
students, 1 1 (Oct) 

MARCUS, Anthony M. 

The nurse and the sociopathic personality, 
49 (Oct) 

MARITIME UNION STUDY 

CCUSN (A) submits brief to Maritime union 

study, 15 (Oct) 
NBARN submits brief on Maritime union, 
15 (Dec) 

MARY IRENE, Sister 

Bk. rev., 58 (Sep) 

MARY OF CALVARY, Sister 
Bk. rev., 66 (Feb) 

MATERNAL HEALTH AND WELFARE 

A descriptive study of the behavior mothers 
exhibit, in response to each other . . . 
(Saunders), (abst), 50 (Sep) 

Safe care for mother and baby, (Dicker), 31 
(Dec) 

MATTHEWS, C. J. 

Quality of care makes the difference, 50 
(Nov) 

MEASLES 

First licence granted for Rubella vaccine, 20 
(Aug) 

MEDICAL ILLUSTRATION 

Medical illustration - an art and a science, 
(Gagnon), 42 (Jun) 

Medical photography - a century of prog- 
ress, (Doyon), 40 (Jun) 

MELNYK, Emily 

Epidermolysis bullosa, 33 (Feb) 

MEMORIAL UNIVERSITY 

First nurses graduate from Memorial Univer- 
sity, 8 (Jul) 

MEN NURSES 

Quebec male nurses seek legal recognition, 
19 (Apr) 

MENTAL HEALTH 

CMHA approves volunteer services for 
emotionally disturbed children, 8 (Jul) 

MENZIES, D. W. 

Bk. rev., 70 (Feb) 

MERTZ, Hilda 

Appointed to the faculty. University of 
Toronto School of Nursing, 18 (Jan) 

MILITARY NURSING 

The bluebirds who went over, (Hacker), 31 

(Nov) 
Nurses hold memorial service, 12 (Jan) 
Nursing sister receives OBE, 1 7 (Mar) 
XII 



MILLER, Donna C. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

MILLER, Kathleen R. 
CNF award, 9 (Sep) 

MILLER, T. M 

Public relations officer of MARN, (port), 20 
(Dec) 

MINKUS, Judy 

Recipient of the Margaret MacLaren Bursa- 
ry, 1 1 (Oct) 

MINER, Louise 

Three nurses appointed to federal task 
forces, 8 (Apr) 

MITCHELL, Beverly 

Appointed to the faculty, University of 
Toronto School of Nursing, 18 (Jan) 

MITCHELL, Eleanor 

Asistant, editor. The Canadian Nurse, 
(port), 22 (Apr) 

MITCHELL, Elizabeth H. 

Honorary member SRNA, 22 (Aug) 

MONTGOMERY, MicheUne 

Bk. rev., 51 (Nov) 

MONTREAL GENERAL HOSPITAL 

Gift to CNA Archives, 9 (Jan) 

MOORE, Edna L. 

Obituary, 22 (Apr) 

MOSS, Frances May 

Executive secretary, (port), 24 (Feb) 

MOTIUK, Margaret A. 

Appointed assistant director of nursing, 
Rockyview Hospital, Calgary, (port), 20 
(Jun) 

MOTTA, Grace 

Retires, 18 (Sep) 

MOVER, Patricia A. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

MRAZEK, Margaret L. 
CNF award, 9 (Sep) 

MUMBY, Dorothy M. 

Bk. rev., 49 (Jun) 

MUNRO, John 

A challenge that confronts us, 40 (Aug) 

MURRAY, Audrey 

Director of nursing service, St. Paul's Hospi- 
tal, Vancouver, (port), 20 (Jun) 

MURAKAMI, T.Rose 

CNF award, 9 (Sep) 

MURPHY, Frances 

Lecturer, U. of Alberta, (port), 22 (Feb) 

MUSSALLEM, Helen K. 

CNA executive director honored, 10 (Dec) 

Canadian elected chairman of PAHO nursing 

committee, 7 (Jan) 
Message from the executive director, 3 

(May) 



Press conference at CNA House, (port), 16 
(Jul) 

MYLES, Margaret F. 

Honorary member SRNA, 22 (Aug) 



N 



NAEGELE, Kaspar 

Naegele fund trustees report on progress of 
children, 20 (Apr) 

NAGANO, Sada 

Nursing in Japan, 35 (Jun) 

NAMES 

18 (Jan), 21 (Feb), 17 (Mar), 22 (Apr), 18 
(May), 20 (Jun), 16 (Jul), 21 (Aug), 17 
(Sep), 22 (Oct), 18 (Dec) 

NANCE, J. Leith 

Lecturer, University of Alberta, (port), 22 

(Feb) 
On the delegation of responsibiUty, 29 

(Nov) 

NAPKE, E 

Drug adverse reaction program - and the 
nurse's role, 40 (Dec) 

NATIONAL LEAGUE FOR NURSING 

Conference to consider health in communi- 
ty, 15 (Apr) 

Margaret E. Walsh, general director, 22 
(Oct) 

NATIONAL MANPOWER CONFERENCES 

Health care fragmented labor leader tells 
assembly, 1 1 (Nov) 

NATIONAL NURSE WEEK 

Minister announces national nurse week, 15 
(Jun) 

NERA, N. 

Bk. rev., 54 (Sep) 

NEUFELD, A. H. 

Qinical laboratory procedures, (Watson), 41 
(Feb) 

NEUROLOGY 

Canadian Neuro Nurses form association, 13 
(Sep) 

NEVITT, Joyce 

Bk. rev., 47 (Dec) 

NEW BRUNSWICK ASSOCIATION 
OF REGISTERED NURSES 

Achieves record high membership, 15 (Dec) 

Awards scholarships, 21 (Nov) 

Employment relations officer, Glenna 
Rowsell, (port), 21 (Aug) 

Holds meeting to vote on fee increase, 2 
(Nov) 

Hospital nurses in NB submit mass resigna- 
tion, 8 (Aug) 

New Brunswick nurses sign new contract, 14 
(Dec) 

New Brunswick nurses withdraw resigna- 
tions, 10 (Sep) 

Nurses negotiations with NBHA deadlocked, 
8 (Jul) 

Organizes for collective bargaining, 13 (Jan) 

Presidents' conference, 14 (Mai) 



NEW BRUNSWICK ASSOCIATION 
OF REGISTERED NURSES 

Submits brief on Maritime union, 15 (Dec) 
Two nurses honored, 22 (Aug) 

NEW PRODUCTS 

22 (Jan), 27 (Feb), 28 (Apr), 24 (May), 26 

(Jun), 17 (Jul), 24 (Aug), 22 (Sep), 24 

(Nov), 22 (Dec) 
NEWS 

7 (Jan), 7 (Feb), 7 (Mar), 7 (Apr), 9 (May), 

9 (Jun), 7 (Jul), 7 (Aug), 9 (Sep), 11 

(Oct), 1 1 (Nov), 9 (Dec) 

NIGHT NURSING 

RNABC urges protection for nurses, 19 
(Nov) 

NIGHTINGALE, Helen T. 

Bk. rev., 58 (May) 

NORMA, Dick 

Appointed to the faculty, University of 
Toronto School of Nursing, 18 (Jan) 

NORMANDIN, Alberta 

Honorary member SRNA, 22 (Aug) 

NURSES, INTERCHANGE OF 

Charge made for study tours to UK, 21 
(Apr) 

NURSING 

ANPQ committees discuss uniform nursing 
techniques, 13 (Jan) 

ANPQ to study nursing profession in Que- 
bec, 10 (Sep) 

CNA executive director predicts change in 
science of nursing, not in art of nursing, 
12 (Dec) 

A challenge that confronts us, (Munro), 40 
(Aug) 

Qinical nursing statement revised by CNA 
board, 1 1 (Dec) 

An exploratory study of the professionaliza- 
tion of Registered Nurses in Ontario and 
the implications for the support of change 
in basic nursing educational programs, 
(Kergin), (abst), 52 (Sep) 

The growth and development of a profes- 
sion, (Bridges), 32 (Jun) 

Internationally-known nurses debate prac- 
tice of nursing at ICN interest session, 14 
(Aug) 

Nurses are not neurotic, (Cohen), 45 (Jun) 

NURSING - FOREIGN COUNTRIES 

New Zealand nurse visits CNA, 18 (May) 
Nursing in Colombia, (Restrepo, Garzon), 

37 (Jun) 
Nursing in Japan, (Nagano), 35 (Jun) 
Peruvian adventure, (Daveluy), 36 (Sep) 
NURSING CARE 

A challenge that confronts us, (Munro), 

40 (Aug) 
Continuity of patient care discussed by ICN 
panelists, 14 (Aug) 
Nursing the patient after heart surgery, 

(Wass), 35 (Jan) 
Team work: the way to play the game, 

(Howard), 29 (Aug) 
Relationship between attitude and person- 

centeredness of nursing care, (Perry), 

(abst), 44 (Dec) 



The relationship between continuity of 
nurse-patient assignment and the patient's 
knowledge of self-care, (Purushotham), 
(abst), 52 (May) 

A study of the relationship between the 
information about the patient as' a 
person . . . (MacKenzie), (abst), 47 (Jan) 

A study to determine - is the nurse in a 
double-bind when caring for patients on 
isolation care? (Peterson), (abst), 46 (Jan) 

Unit assignment - a new concept, 
(Sjoberg), 29 (Jul) 
NURSING HOMES 

Communal dining, (Mclver), 45 (Apr) 

Nursing home administration course starts 
in Ontario, 14 (Dec) 
NURSING EDUCATION 

See Education 

NURSING MANPOWER 

ANA releases current RN data, 16 (Dec) 
MARN co-sponsors program for inactive 
nurses, 16 (Jan) 
see also Health manpower 

NURSING SERVICE 

Ad Hoc committee completes draft for 
standards for nursing service, 7 (Jul) 

Criteria used by employers when selecting 
nursing staff in varying sized hospitals, 
(Trout), (abst), 52 (Sep) 

Draft standards to be tested, 10 (Mar) 

Guide on nursing service standards to be 
published by CNA, 1 1 (Dec) 

Nurses for nursing, (Palmer), 36 (May) 

Nursing organization - circa 1969, (Ste- 
wart), 59 (Feb) 

Nursing supervisors' perception of their 
functions and activities, (Crotin), (abst), 
48 (Jun) 

Student nurses debate role of the supervisor, 
18 (Jun) 

A study to determine the influence of 
selected factors in choosing a head nurse's 
position, (Proulx), (abst), 48 (Jun) 

A study to determine who, in the opinion of 
nurses and physicians, should be responsi- 
ble for teaching the hospitalized patient, 
(Shantz), (abst), 52 (May) 

A study to explore the relationship between 
absence events . . ., (Wilson), (abst), 46 
(Jan) 

"Too many supervisors" RNABC meeting 
told, 10 (Jul) 
NURSING TEAM 

Pembroke hospital sponsors team nursing 
workshop, 14 (Jan) 

Team nursing workshops held in Alberta, 10 
(Jun) 

Team work: the way to play the game, 
(Howard), 29 (Aug) 



OBERHOLTZER, Rene 

Lecturer, U. of Alberta, (port), 22 (Feb) 



O'BRIEN. Beverly 

RNABC bursary, 21 (Nov) 

O'BRIEN, Moira L. 
Bk. rev., 54 (Sep) 



OBSTETRICS 

A descriptives study of the behavior 

mothers exhibit . . ., (Saunders), (abst), 50 

(Sep) 
Father should dominate says Hamilton 

doctor, 16 (Jan) 
Quality of care makes the difference, 

(Matthews), 50 (Nov) 
Rooming-in brings family together, 

(Coome), 47(Jun) 
Safe care for mother and baby, (Dicker), 31 

(Dec) 
Women's feelings about the figure change in 

pregnancy, (McEwan), (abst), 53 (May) 

OCCUPATIONAL HEALTH 

Sub-committee on occupational health 
meets in London, 10 (Feb) 

O'CONNOR, Helen 

Bk. rev., 49 (Apr) 

ONTARIO HOSPITAL ASSOCIATION 

"Write it down" OHA panel suggests, 13 
(Dec) 

ONTARIO HOSPITAL SERVICE 
COMMISSION 

OHSC raises bonus rates for service person- 
nel; teachers' bonuses remain same, 9 
(Jan) 

OPERATING ROOM 

OR nurses discuss infection in hospitals, 10 

(Feb) 
OR technicians form association, 12 (Oct) 
Operating room nurses meet, 1 7 (Dec) 

ORDERLIES 

Orderly training program to open in BC in 
fall, 14 (Jul) 

OTTAWA UNIVERSITY. 
SCHOOL OF NURSING 

Appointments, 18 (Sep) 
Student nurses debate role of the supervisor, 
18 (Jun) 



PALMER, Helen 

Nurses for nursing, 26 (May) 

PAN AMERICAN HEALTH 
ORGANIZATION 

Canadian elected chairman of PAHO nursing 
committee, 7 (Jan) 

PANKRATZ, SteUa 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

PAPADOPOULLOS. Andreas 

Recipient of the Margaret MacLaren Bursa- 
ry, 11 (Oct) 

PARKIN, Margaret L. 

Resources and use of CNA library, 32 (Mar) 

PASK, Eleanor G. 

Collecting urine specimens from children, 
35 (Oct) 

PATIENTS 

Helping the patient face reality, (Arnold), 
41 (Sep) 

XIII 



It's depressing! (Costello), 43 (Sep) 
Quality of care makes the difference, 
(Matthews), 50 (Nov) 

PATON, Nora 

Director of personnel services, RNABC, 
(port), 22 (Aug) 

PECHIULIS, Diana D. 

CNF award, 9 (Sep) 

PEDIATRICS 

Butterfuly with a broken wing, 20 (Apr) 
The child with leukemia, (Cragg), 30 (Oct) 
Collecting urine specimens from children, 

(Pask), 35 (Oct) 
Parents participate in care of the hospitaliz- 
ed child, (MacDonald), 37 (Dec) 
Quebec school children suffer from mal- 
nutrition, 15 (Oct) 
The relationship between the physical ad- 
justment of children to diabetes . . . (Lane), 
(abst), 46 (Jan) 

Survey of follow-up of visual defects in 
grade one school children in central Alber- 
ta health units, (Smith), (abst), 49 (Aug) 
Two-year-old Michael - ill and in hospital, 
(Bumie), 46 (Nov) 

PEEVER, Mary 

Appointed chairman, department 6f nursing 
education at Mount Royal Junior Colege, 
(port), 18 (Jan) 

PENSIONS 

Old age pension to increase in 1970, 20 
(Oct) 

PEPLAU, Hildegard 

Interim executive director appointed by 
ANA, 19 (Aug) 

PERIODICAL PRESS ASSOOATION 

Answers editorial on postal rates, 13 (Dec) 

PEQUEGNAT, Dorothy 

Bk. rev., 66 (Feb) 

Infections in the hospital, 27 (Mar) 

PERRY, Sheila E. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

PERRY, Susan 

Relationship between attitude and person- 
centeredness of nursing care, (abst), 44 
(Dec) 

PESTELL, Derek 

Bk. rev., 59 (May) 

PESZAT, Lucille C. 

Appointed coordinator of formal continuing 
education programs, RNAO, (port), 17 
(Sep) 

PETERS, Blondina F. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

PETERSON, Alva L. 

A study to determine - is the nurse in a 
double-bind when caring for patients on 
isolation care? (abst), 46 (Jan) 

PETTIGREW, LiUian 

CNA associate director to participate in 
XIV 



WHO conference in New Delhi, 11 (Oct) 
Official opening of MARN headquarters, 
(port), 10 (Mar) 

PHARMACOLOGY 

A "two-way" street, (M. Liguori), 30 (Mar) 

PHILLIPS, A.J. 

Smoking habits of Canadian nurses and 
teachers, 40 (Apr) 

PHYSICIANS' ASSISTANT 

Editorial, (Lindabury), 3 (Jan) 
A new category of health worker for Cana- 
da? (Hacker), 38 (Jan) 

PISHKER, Frances 
Bk rev., 50 (Jan) 

PITT, Shirley E. 

Bk rev., 52 (Jan), 66 (Feb) 

POOLE, PameU 

Time out at the Canadian Hospital Associa- 
tion convention, 10 (Jul) 

POST, Shirley 

Inservice for teachers, too? 29 (Sep) 

POSTAL RATES 

"Canadian Hospital" attacks new postal 
rates, 16 (Sep) 

POSTMORTEM EXAMINATIONS 

Student observation at postmortem exami- 
nations, (Lindabury), 57 (Feb) 

PRACTICAL NURSING 

Nursing assistants are here to stay, (Kergin), 
33 (Apr) 

PRINGLE, Dorothy M. 

Bk. rev., 51 (Jun) 

The use of a conceptual model to evaluate 

psychiatric nursing therapy, Pringle (abst), 

45 (Dec) 

PRIVATE DUTY NURSES 

Keep the private duty directories running, 

(Jamieson), 45 (Jan) 
Private duty - private choice, (Hacker), 25 

(Jul) 

PROULX, Yolande 

A study to determine the influence of 
selected factors in choosing a head nurse's 
position, (abst), 48 (Jun) 

PROSTHESES 

The amputee and immediate prosthesis, 
(Shewchuk), (Young), 47 (May) 

PSYCHIATRIC NURSING 

Come with me, Lori, (Warwick, Wilting), 48 

(Sep) 
The nurse and the sociopathic. personality, 

(Marcus), 49 (Oct) 
The use of a conceptual model to evaluate 

psychiatric nursing therapy, (Pringle), 

(abst), 45 (Dec) 

PSYCHIATRY 

Guilt: an operationally defined concept, 

(Kliewer), (abst), 50 (Sep) 
Psychodrams, (Burwell), 44 (May) 
Summer camp holiday for Douglas Hospital 

patients, 16 (Sep) 



Too much treatment a danger warns ICN 
psychiatry paneUst, 16 (Aug) 

PSYCHOLOGY 

It's depressing! (Costello), 43 (Sep) 

PUBLIC HEALTH NURSING 

A comparison of the perceptions of public 
health nurses and their alcoholic pa- 
tients . . . (Williams), (abst), 52 (May) 

Family health service; the PHN and the GP, 
(Jones, Bondy), 38 (Sep) 

A guide for the public health nurse to assist 
elderly patients in the achievement of 
selected functional tasks at home, (Wil- 
son),|Kabst), 50 (Sep) 

PUBLIC RELATIONS 

CNA sends suggestions to task force on 

information, 10 (Feb) 
(Theck your image - it's slipping! (Zilm), 

45 (Oct) 
Editorial, (Lindabury), 3 (Oct) 
UR a PR for ICN, says PRO, 9 (Feb) 

PURUSHOTHAM, Devamma 

The relationship between continuity of 
nurse-patient assignment and the patient's 
knowledge of self-care, (abst), 52 (May) 



QUEBEC COMMISSION ON 
HEALTH AND WELFARE 

University nurses present brief to Caston- 
guay Commission, 12 (May) 

QUEBEC SOCIETY FOR 
CRIPPLED CHILDREN 

Butterfly with a broken wing, 20 (Apr) 

QUINN, Sheila 

International forum in Montreal, (editorial), 
3 1 (Jun) 

QUITTENTON, R. C. 

Community colleges and nursing education 
in Ontario, (abst), 46 (Jan) 



R 



RAJCSANYI, Dorothy E. 

Associate director of education, VON, 
Greater Montreal branch, 22 (Jun) 

REBAN, Catherine 

Instructor, Mount Royal Junior College, 
(port), 18 (Jan) 

RECRUITMENT 

Male student wins recruitment poster 
contest, 14 (Jul) 

RECTOR, Laurel 

Employment relations officer of MARNj 
(port), 20 (Dec) 

RED CROSS 

see Canadian Red Cross 

REGINA GREY NUNS' 
HOSPITAL 

Two-year versus three-year programs 
(Costello, Castonguay), 62 (Feb) 

REFRESHER COURSES 

Making a comeback, (Kowalchuk, 29 (Oct) 



REGISTERED NURSES' ASSOCIATION 
OF BRITISH COLUMBIA 

Alberta and British Columbia announce 

contributions to ICN, 13 (Mar) 
Announces awards, 21 (Nov) 
BC nurses begin two workshops, 16 (Jan) 
Contributions to ICN reach $8,400, 9 (May) 
Donates $5,000 to CNA for ICN costs, 14 

(Jan) 
Elects new officers, 7 (Jul) 
Loans offered, 16 (May) 
Mature students to be admitted to BC 

schools of nursing, 16 (Jun) 
"Too many supervisor" RNABC meeting 

told, 10 (Jul) 
Urges protection for nurses, 19 (Nov) 

REGISTERED NURSES' ASSOCIATION 
OF NOVA SCOTIA 

Considers principles of curriculum building, 

8 (Jul) 
Executive secretary, Frances May Moss, 

(port), 24 (Feb) 
Honorary memberships, 22 (Aug) 
Several reasons for drop in enrollment, says 

RNANS, 9 (Feb) 
Two-year programs discussed at RNANS 

annual meeting, 19 (Aug) 

REGISTERED NURSES' 
ASSOCIATION OF ONTARIO 

Delegates approve affiliate status, 12 (Jun) 

Elects new officers, 20 (Jun) 

Holds regional conferences on audiovisual 

aids, 9 (Jan) 
Honorary life membership for Gladys 

Sharpe, 22 (Jun) 
Nursing associations - are they coming or 

going? (ZUm), 31 (Sep) 
New director of employment relations, 18 

(May) 
Ontario supreme court to settle terms of 

nurses' contract, 14 (Sep) 
Plans programs for ICN visitors, 14 (Apr) 
Possible change in RNAO bylaws, 13 (Jan) 
Recommends $7,000 as minimum salary for 

RN, 14 (Jun) 
Students discuss pros and cons of own 

provincial association, 12 (Jun) 

REHABILITATION 

The amputee and immediate prosthesis, 
(Shewchuk, Young), 47 (May) 

ICN interest session debates role of rehabili- 
tation nurse, 17 (Aug) 

R£ID, Helen Evans 
Bk. rev., 50 (Jun) 

REID, Winnifred M. 

Director of nursing at Bumaby General 
Hospital, (port), 20 (May) 

REIGHLEY, Ronald S. 

CNF award, 9 (Sep) 

RESEARCH 

CNA Library wants theses, 1 2 (Oct) 
Index of Canadian nursing studies available, 
16 (Jun) 

RESEARCH ABSTRACTS 

46 (Jan), 52 (May), 48 (Jun), 49 (Aug), 
50 (Sep), 44 (Dec) 



RESTREPO, Lucia A. 

Nursing in Colombia, (Garzon), 37 (Jun) 

RHEAULT, M. Claire 

A comparison of students' achievement on a 
sequential learning experience with other 
measures of student" progress, (abst), 47 
(Jan) 

RICHARD, Hubert, Sister 

A study of the attitudes of nurse faculty 
members in a selected Canadian province 
in relation to their educational functions, 
(abst), 53 (May) 

RICHMOND, Mary L. 
Bk. rev., 46 (Apr) 

RIEHL, Joyce 

The Countess Mountbatten Bursary for 
students, 1 1 (Oct) 

RILEY, Marilyn S. 
CNF award, 9 (Sep) 

RIPPON, Maiion 

An unlikely author, 20 (Aug) 

RITCHIE, Judith A. 

CNF award, 9 (Sep) 

RIVARD, Virginia 
Bk. rev., 52 (Nov) 

ROWS ELL, Glenna 

Employment relations officer, NBARN, 
(port), 21 (Aug) 

ROYAL COLLEGE OF NURSES 

Against voluntary euthanasia, 15 (Jul) 
Charge made for study tours to UK, 21 
(Apr) 

RYAN, Sheila M. 

CNF award, 9 (Sep) 

RYERSON INSTITUTE, TORONTO 

Ryerson Institute offers short courses for 
RNS, 20 (Nov) 

RYMER, SheUa 
Bk. rev., 69 (Feb) 



SABOURIN, Marie Therese 

New director, nursing service, RNABC, 
(port), 17 (Mar) 

SAFETY 

RNABC urges protection for nurses, 19 
(Nov) 

SALARIES 

See Economics, Nursing 

SANE, OUvia M. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

STE-CROIX, Armande Sister 

Honorary member SRNA, 22 (Aug) 

ST. JAMES, Peter 

Insulin injection - a new technique, 32 
(Jul) 

ST. JOHN AMBULANCE 

St. John Ambulance announces bursary 
awards, 1 1 (Oct) 



ST. JOSEPH'S HOSPITAL, 
GUELPH 

Breakthrou^ for nurses at St. Joseph's 
Hospital Guelph, 12 (Oct) 

SANDILANDS, Maijorie 

Lecturer, U. of Alberta, 22 (Feb) 

SASKATCHEWAN INSTITUTE OF 
APPLIED SCIENCES 

Sixteen new instructors, 22 (Apr) 

SASKATCHEWAN REGISTERED 
NURSES ASSOCIATION 

Announced retirement of Grace Motta, 18 

(Sep) 
Announces annual CNF donation, 13 (Mar) 
Contracts signed by Saskatchewan Nurses, 

20 (Nov) 
Eight former nurses awarded honorary 

memberships, 22 (Aug) 
Madge McKillop elected President, 18 (Dec) 

SASKATOON UNIVERSITY HOSPITAL 

Unit assignment - a new concept, 

(Sjoberg), 29 (Jul) 
SAUNDERS, Peggy 

A descriptive study of the behavior mothers 

exhibit . . ., (abst), 50 (Sep) 

SCANLAN, Judith M. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

SCHAAP, Margaret Isobel 

Director of nursing, Winnipeg Municipal 
Hospital, 21 (Feb) 

SCHUMACHER, Marguerite 

Less paperwork and bureaucracy if nursing 
is to survive, 16 (Jun) 

SCOTT, Mary Jane 

NBARN scholarship, 21 (Nov) 

SEIVWRIGHT, Mary Jane 

Appointed nurse adviser. International 
Council of Nurses, (port), 20 (Jun) 

SEYMOUR, Cath e rine M. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

SHACK, Joyce O. 

Director of nursing service, Plummer 
Memorial Public Hospital, Sault Ste. Ma- 
rie, (port), 23 (Apr) 

SHANNON, Julia E. 
CNF award, 9 (Sep) 

SHANTZ, Shirley Jean 

A study to determine who, in the opinion of 
nurses and physicians, should be responsi- 
ble for teaching the hospitalized patient, 
(abst), 5 2 (May) 
SHARPE, Gladys 

Awarded an honorary doctor of laws degree, 
22 (Oct) 

Honorary life membership in the RNAO, 22 
(Jun) 

SHATTUCk, Audrey M. 

Honorary member SRNA, 22 (Aug) 



SHERRARD, Myma 
Bk. rev., 47 (Dec) 



XV 



Three nurses appointed to federal task 
forces, 8 (Apr) 

SHEWCHUK, M. 

The amputee and immediate prosthesis, 
(Young), 47 (May) 

SHIRLEY, S. Y. 

Bk. rev., 49 (Jun) 

SILVERTHORN, A. 

Psoriasis - The stubborn malady 38 (Nov) 



SJOBERG, Kay 

Unit assignement 
(Jul) 



a new concept, 29 



SKIN DISEASES 

Epidermolysis bullosa, (Melnyk), 33 (Feb) 
Poison ivy, (editorial), (Lindabury), 3 (Sep) 
Psoriasis - The stubborn malady, (Silver- 
thom), 38 (Nov) 

SLATER, Myrna 

Director of the division of public health 
nursing, Toronto, (port), 18 (Sep) 

SLINGER, S. J. 

Bk. rev., 52 (Aug) 

SMALLPOX 

Lady Mary Wortley Montagu - eighteenth 
century crusader, (Grant), 34 (Jul) 

SMOKING 

Smoking habits of Canadian nurses and 
teachers, (Phillips), 40 (Apr) 

SMITH, Dorothy (McPhail) 

Survey of follow-up of visual defects in 
grade one school children in central Alber- 
ta health units, (abst), 49 (Aug) 

SMITH, Ethel M. 

CNF award, 9 (Sep) 

SMITH. Lois 

Honorary membership NBARN, 22 (Aug) 

SMITH, Roselyn 
Bk. rev., 53 (Aug) 

SNIVELY, Mary Agnes 

The growth and development of a profes- 
sion by Daisy C. Bridges, (port), 32 (Jun) 

SOCIETIES, NURSING 

Nursing associations - are they coming or 
going? (ZUm), 31 (Sep) 

Relationships between attitudes to nursing, 
job satisfaction and professional organiza- 
tion membership, (Bailey), (abst), 52 
(May) 

See also names of nurses associations 

SPECIALISM 

The nurse is a specialist in the artificial 
kidney unit, (Frye), 33 (Dec) 

STAFFING 

Criteria used by employers when selecting 
nursing staff in varying sized hospitals, 
(Trout), (abst), 52 (Sep) 
MARN surveys staffing patterns, 12 (May) 
Unit assignement - a new concept, 
(Sjoberg), 29 (Jul) 
XVI 



STAINTON, M. CoUen 

Instructor, Mount Royal Junior College, 
Calgary, (port), 23 (Apr) 

STARR, Dorothy S. 

Assistant professor of nursing, Ottawa 
University, (port), 21 (Aug) 

STATISTICS 

ANA releases current RN data, 16 (Dec) 
CNA works with DBS to pubhsh statistics, 
12 (Nov) 

STEED, Margaret E. 

Appointed consultant in Alberta, (port), 21 
(Feb) 

STEPHENS, Shirley W. 

Bk. rev., 56 (May) 

STEPHENSON, M. Jane 

Honorary membership NBARN, 22 (Aug) 

STEVENSON, Doris D. N. 

Director of nursing education at Holy Cross 
Hospital in Calgary, 22 (Feb) 

STEVENSON, Edith G. 

Retired, Ottawa Branch of Medical Services, 
(port), 22 (Aug) 

STEVENSON, Helen T. 

Appointed director of Nursing, Saskatche- 
wan Institute of Applied Arts and Sci- 
ences, Saskatoon, (port), 17 (Sep) 

STEWART, Diane Y. 

Nursing organization - circa 1969, 59 
(Feb) 

STINSON, Shirley M. 

Appointment on faculty of the University 
of Alberta, (port), 20 (Jun) 

STONE, Jennifer 

RN ABC bursary, 21 (Nov) 

STUCKER, Beatrice E 

Nurse consultant, maternal and child health 
service for Ontario, 20 (Dec) 

STUDENTS 

A comparison of students' achievement on a 
sequential learning experience with other 
measures of student progress, (Rheault), 
(abst), 47 (Jan) 

Correlates of approval and disapproval re- 
ceived by students at selected schools of 
nursing, (Hayward), (abst), 52 (Sep) 

Effectiveness of cUnical instructors as per- 
ceived by nursing students, (Joseph), 
(abst), 44 (Dec) 

McMaster student nurses request financial 
aid, 19 (Aug) 

Mature students to be admitted to BC 
schools of nursing, 16 (Jun) 

Students discuss pros and cons of own 
provincial association, 1 2 (Jun) 

Students want voice at ICN begin to speak 
out on issues 7 (Aug) 

SURGERY 

Advances in surgery for coronary artery 

disease. (Trimble), 32 (Jan) 
Nursing the patient after heart surgery, 

(Wass), 35 (Jan) 



The value of revascularization surgery, 
(Vineberg), 28 (Jan) 

SURRING, Nevin N. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

SUTHERLAND, Jean 

New Zealand nurse visits CNA, 18 (May) 

SYMON, Mary A. 

Instructor, Sask. Institute of Applied Sci- 
ences, 23 (Apr) 

SYPOSZ, Dorothy 

Bk. rev., 68 (Feb) 



TANNER, Grace 

Gift to CNA Archives, 9 (Jan) 
TASK FORCE ON LABOUR 
RELATIONS 

CNA sends suggestions, 10 (Feb) 

TAYLOR, Effie J. 

The growth and development of a profes- 
sion by Daisy C. Bridges, (port), 32 (Jun) 

TELEVISION 

Family physicians meeting sees debut of 
medical convention T.V., 17 (Dec) 

TESTS AND MEASUREMENTS 

CNA testing service to be located in Ottawa, 

8 (Mar) 
A comparison of students' achievement on a 

sequential learning experience with other 

measures of student progress, (Rheault), 

(abst), 47 (Jan) 
First Quebec hospital goes metric, 15 (Dec) 
How much bleeding? (Bruser), 44 (Jan) 
Metric conversion kits available 
from C.H.A. 13 (Dec.) 

Provisional board to be set up for CNA 

testing service, 10 (Dec) 
Schools evaluate tests as educational aids, 

12 (Jan) 
Workshops on test construction to be held 

in London, 16 (Mar) 

THOMAS, Sharon 

Medication errors can be prevented, 50 

(May) 

THOMPSON, Doris S. 

Bk. rev., 58 (May) 

THORNE, Anne D 

First director Saint John School of Nursing, 
New Brunswick, 20 (Dec) 

3M COMPANY 

3M donates fellowship, 10 (Aug) 

TISSINGTON, F. Qaire 

An exploratory study of the relationship 
between physical and social-psychological 
distance and nurse-patient verbal inter- 
action, (abst), 44 (Dec) 

TOD, M. Louise 

Harder bargaining ahead for Canadian 
nurses, 18 (Jun) 



TORONTO UNIVERSITY. 
SCHOOL OF NURSING 

Appointments to faculty, 18 (Jan) 

TRANSPLANTATION 

A moral and legal look at organ transplants, 
12 (Jul) 

TRETIAK, Sally 
Bk. rev., 28 (Jul) 

Joins teaching staff of Red Deer Junior 
College, (port), 18 (Jan) 

TRIMBLE, A. S. 

Advances in surgery for coronary artery 
disease, 32 (Jan) 

TROUT, Margaret F. 

Criteria used by employers when selecting 
nursing staff in varying sized hospitals, 
(abst), 52 (Sep) 

TURNBULL, LUy M. 

Chief nursing officer of the World Health 
Organization, 20 (Jun) 



u 



UNIFORMS 

Haute couture on the wards, 13 (Jan) 
Check your image - it's slipping! (Zilm), 
45 (Oct) 

UNITED NURSES OF MONTREAL 

Elects new officers, 14 (Feb), 20 (Nov) 
Executive coordinator, Nicole Dion, 17 

(Sep) 
Hold second annual meeting, 12 (Jan) 
Montreal nurses sign contract with Queen 

Elizabeth Hospital, 14 (Feb) 

UNIVERSITY OF ALBERTA 

Faculty appointments, 22 (Feb) 

UNIVERSITY OF BRITISH COLUMBIA 

CNA Executive director predicts change in 

science nursing, 1 2 (Dec) 
UBC celebrates golden jubilee, 8 (Mar) 

UNIVERSITY OF MONTREAL 

U. of M. graduates form alumi association, 
16 (Feb) 

UNIVERSITY OF WESTERN ONTARIO 

Two workshops at UWO, 20 (Aug) 



VACCINATION 

Lady Mary Wortley Montagu - eighteenth 
century crusader, (Grant), 34 (Jul) 

VAN BERGEN, Hilda 

RNABC bursary, 21 (Nov) 

VAN RAALTE, Ernest 

Thought and action, 25 (Mar) 

VAN TROYEN, Phyllis 
Bk. Rev., 50 (Aug) 

VARCO, Doris Ann 

Margaret Sinn Fund bursary, 21 (Nov) 

VICTORIAN ORDER OF NURSES 
Holds 71st annual meeting, 15 (Jun) 



VINEBERG, Arthur 

The value of revascularization surgery, 28 
(Jan) 



w 



WALKER, Karen V. 

Assistant director of nursing Qarke Institute 

of Psychiatry, (port), 22 (Aug) 
Bk. rev., 56 (May) 

WALLINGTON, Marjorie A. 

An approach to the phases of nurse-patient 
relationships, (abst), 50 (Sep) 

WASLSH, Margaret E. 

General director of the National Leagae for 
Nursing, 22 (Oct) 

WARNER, Dorothy 

Deceased, 22 (Oct), 18 (Dec) 

WARWICK, Lorraine E. 

Come with me, Lori, (Wilting), 48 (Sep) 

WASS, Judith R. 

Nursing the patient after heart surgery 35 
(Jan) 

WASSON, Dorothy 
Bk. rev., 51 (Nov) 

WATSON, E. M. 

Qinical laboratory procedures, (Neufeld), 
41 (Feb) 

WHITAKER, Judith 

Press conference at CNA House, (port), 16 

(Jul) 

WHITE SISTER UNIFORM INC. 

White Sister donates $30,000 scholarship, 
10 (Aug) 

WHITNEY, Marie 

Assistant director, school of nursing, St. 
Paul's Hospital, Vancouver, 10 (Jun) 

WHITTON, Charlotte 

Gold chain honors nurses, 7 (Jul) 

WIEBE, Lydia 

Director of nursing service for Grace Gene- 
ral Hospital, Winnipeg, (port), 20 (May) 

WILLIAMS, Marguerite C. 

A comparison of the perceptions of public 
health nurses and their alcoholic pa- 
tients . . . (abst), 52 (May) 

WILSON, Hazel A. 

Appointed to the Ontario Department of 
Health, (port), 18 (Jan) 

A study to explore the relationship between 
absence events and the scheduling of time 
and work assignements . . . (abst), 46 (Jan) 

WILSON, PhyUis Margaret A. 

A guide for the public health nurse to assist 
elderly patients (abst), 50 (Sep) 

WILTING, Jennie 

Come with me, Lori, (Warwick), 48 (Sep) 

WOOD, Sheila 

Hemodialysis in the home, 42 (Apr) 



WOOD, Vivian 

Bk. Rev., 50 (Aug) 

Two workshops at UWO, 20 (Aug) 

WORLD HEALTH ORGANIZATION 

CNA associate director to participate in 
WHO conference in New Delhi, 11 (Oct) 

Chief nursing officer, Lily M. Tumbull, 18 
(Jun) 

New Zealand nurse visits CNA, 18 (May) 

Nurse included in Canadian delegation to 
WHO assembly, 13 (Nov) 

Work in Africa continues, 19 (Oct) 

WRITING 

Nurses reluctant to write ICN delegates told, 

18 (Aug) 
An unlikely author, (Rippon), 20 (Aug) 

WROBEL, D. M. 

Bk. rev., 42 (Mar) 

WYLIE, Norma A. 

Hospital design is a nursing affair, 42 (Oct) 



YEO, Iva J. 

Bk. rev., 68 (Feb) 

YOUNG, Jessie F. 

A new design for stryker turning frame 
covers, 45 (Jan) 

YOUNG, Z. 

The amputee and immediate prosthesis, 
(Shewchuk), 47 (May) 



ZEIDLER, Eberhard H. 

How to prolong a hospital's lifespan, 39 
(Oct) 

ZILM, Glennis 

Bk. rev., 54 (Sep), 51 (Nov) 

Check your image - it's slipping! 45 (Oct) 

Hyperbaric oxygen units - hi^ pressure 

nursing, 37 (Feb) 
Nursing associations - are they coming or 

going? 31 (Sep) 
Plans to do free-lance writing, (port), 21 

(Feb) 

ZITKO, GUdys Anne 

RNABC bursary, 21 (Nov) 



XVII 



PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES 



Alberta 

Alberta Association of Registered Nurses, 
10256 ~ 112 Street, Edmonton. 
Pres.: M.G. Purcell; Vice-Pres.: R. Erickson, A. 
Tetarenko, M. de Hamel; Committees - 
Nurs'g Service: M. Godfrey; Nurs'g Educ: G. 
Bauer; Staff Nurses: I, }Ao^%ey\Super'y Nurses: 
A. Clyne; Prov'l Office Staff - Pub. ReL: D.J. 
LaBelle; Employment Rei: M.L. Tod;Comm;Y- 
tee Advisor: H. Cotter; Registrar: DJ. Price; 
Exec. Secretary: H.M. Sabin; Office Manager: 
M. Garrick. 

British Columbia 

Registered Nurses' Association of British Co- 
lumbia. 2130 West 12th Avenue, Vancouver 9. 
Pres.: M.D.G. Angus; Past Pres.: M. Lunn; 
Vice-Pres.: R. Cunningham, A. Baumgart; //o«. 
Treasurer: T.J. McKenna; Hon. Sec: Sister 
Kathleen Cyr; Committees - Nurs'g Educ: E. 
Moore; Nurs'g Service: N. Stevens; Soc. & 
Econ. Welf: A.l. Mooney; Finance: T.J. 
McKenna; Legislation & By-Laws: C.J. Winning; 
Pub. Rei: B.A. Geddes; Exec. Director: E.S. 
G\a.hdm\ Registrar: H. Grice. 

Manitoba 

Manitoba Association of Registered Nurses, 647 
Broadway Avenue, Winnipeg 1. 
Pres.: D. Dick; Past Pres.: H. Glass; Vice- 
Pres.: E. M. Nugent, O. Gebhard; Com- 
mittees - Nurs'g Service: A. Croteau; Nurs'g 
Educ: K. DeMarsh; Soc. & Econ. Welf: 
L. Abbott; Legislation: M. Wilson; /I ccA-ed/fm^; 
K. McLaughlin; Board of Examiners: M. Nu- 
gent; Educ. Fund: J. Winkler; Finance: H. 
Beath; House: M.E. Wilson; Nurs'g Consultant: 
Sister Beatrice Wambeke; Pub. Rei Officer: Mr. 
T.M. Miller; Registrar: M. Caldwell. Int. Exec. 
Dir: B. Cunnings; Empi Rei Officer: L. 
Rector. 

New Brunswick 

New Brunswick Association of Registered 
Nurses, 231 Saunders Street, Fredericton. 
Pres.: 1. Leckie; Past Pres.: K. Wright; Vice- 
Pres.: H. Hayes, A. Robichaud; Hon. Sec: M. 
MacLachlan; Committees ~ Soc. & Econ. 
Welf: B. Leblanc; Nurs'g Educ: A. Grouse; 
Nurs'g Service: M. Sherrard; Fi/iance.- A. Robi- 
chaud; Legislation: H. Hayes; Exec Sec: M.J. 
Anderson; Registrar: L. Gladney;/4(?i;. Com. to 
Schools of Nurs'g: Sister Florence Darrah; 
Nurs'g Assistants Com.: A. Dunbar. 

Newfoundland 

Asociation of Registered Nurses of Newfound- 
land, 67 LeMarchand Road, St. John's. 
Pres.: E. Summers; Past Pres.: Sister Catherine 
Kenny; Pres. Elect: A. Simms; Vice Pres.: J. 
Nevitt; Committees - Nurs'g Educ: R. Dew- 
ling; Soc <S Econ. Welf: J. Lewis; Exec Sec: 
P. Laracy;/lssr Exec. Sec: M. Cummings. 

XVIII 



Nova Scotia 

Registered Nurses' Association of Nova Scotia, 

6035 Coburg Road, Halifa.x. 

Pres.: J. Fox; Past Pres.: J. Church. Vice Pres.: 

Sister C. Marie, E. Rhindress, E.J. Dobson; 

Committees - Nurs'g Educ: V. Ri\ey: Nurs'g 

Service: F. Gass; Soc. <& Econ. Welf: M. 

Bradley; f.x-ec. Sec: F. Moss; Recording Sec: 

E. MacLaughlin. 



Ontario 

Registered Nurses' Association of Ontario, 33 
Price Street, Toronto 289. 
Pres.: L.E. Butler; Pres. Elect: M.J. Flaherty; 
Committees - Socio-Econ. Welf: E.A. Eagle; 
Nurs'g: M.E. Gourlay; Educator: I. A. Brown; 
Administrator: B.I. Robinson; Exec. Director: 
L. Barr; Asst. Exec. Director: D. Gibney; 
Employment Rei Director: A.S. Gribben; 
Coordinator Formal Contin 'g Educ. Program: 
L.C. Peszat; Director. Prof'l Devei Dept.: D.M. 
Adams; Pub. Rei Officer: 1. LeBourdais; 
Director. Testing Service: D.R. Colquhoun; 
Librarian: F.E. Geddis; Regional Exec. Sec: 
I.W. Lawson; M.I. Thomas, F. Winchester. 



Prince Edward Island 

Association of Nurses of Prince Edward Island, 

188 Prince Street, Charlottetown. 

Pres.: B. Rowland; Past Pres.: Sister Marie 

Cahill; Vice Pres.: E. MacLeod; Pres. Elect.: 
CM. Corbett; Committees - Nurs'g Educ: S. 
DriscoU; Nurs'g Service: F. Gates; /"ui. Rei: C. 
Gordon; Finance: Sister Marie Cahill; Legisla- 
tion & By-Laws: H.L. Bolger; Soc. & Econ. 
Welf: H. Mclnnis; Exec. Sec-Registrar: H.L. 
Bolger. 

Quebec 

Association of Nurses of the Province of Que- 
bec, 4200 Dorchester Blvd. West, Montreal. 
Pres.: H.D. Taylor; Vice-Pres.: (Eng.) R. Atto, 
K. Rowat; (Fr.) M. Jalbert, R. Bureau; Hon. 
Treasurer: M. Ellis; //on. Sec: E. Morin; Com- 
mittees - Nurs'g. Educ: M. Callin, D. Lalan- 
cette; Nurs'g Service: E. Strike, Sister Lorraine 
Beaudin; Labour Rei: M.M. Wheeler, G. Hotte; 
School of Nurs'g.: M. Barrett, P. Provencal; 
Legislation: E.C. Flanagan, G. (Charbonneau) 
Livailee; Sec-Registrar: H.F Reimer. 

Saskatchewan 

Saskatchewan Registered Nurses" Asociation, 
2066 Retallack Street, Regina. 
Pres.: M. McKillop; Past Pres.: A. Gunn; 1st 
Vice-Pres.: E. Linnell; 2nd Vice-Pres.: C. Boy- 
ko; Committees - Nurs'g Educ: J. Byam; 
Nurs'g Service: J. Belfry; Chapters & Pub. Rei: 
M. Harman; Soc. & Econ. Welf: O. Yonge; 
Exec. Sec: A. Mills; Registrar: E. Dumas; 
Employment Rei Officer: A.M. Sutherland. 



YV CANADIAN 

S^ ASSOCIATION 



Board of Directors 

President Sister M. Felicitas 

President Elect E. Louise Miner 

1st Vice- 
president Marguerite Schumacher 

2nd Vice- 
president Margaret D. McLean 

Representative of Nursing 

Sisterhoods Sister J. Bouchard 

Chairman of Committee on Social & 

Economic Welfare Louise Tod 

Chairman of Committee on Nursing 

Service Margaret D. McLean 

Chairman of Committee on Nursing 

Education Kathleen E. Arpin 

AARN M.G. Purcell, President 

RNABC M.D.G. Angus, President 

MARN D. Dick, President 

NBARN I, Leckie, President 

ARNN E. Summers, President 

RNANS J. Fox, President 

RNAO L.E. Butler, President 

ANPEI B. Rowland, President 

ANPQ H.D. Taylor, President 

SRNA M. McKiUop, President 



National Office 

Executive 

Director Helen K. Mussallem 

Associate Executive 

Director Lillian E. Pettigrew 

General 

Manager Ernest Van Raalte 

Research and Advisory Services 

Director Lois Graham-Cumming 

Nursing 

Coordinator Harriett J.T. Sloan 

Library, Margaret L. Parkin 

Information Services: 

Public Relations Valerie Fournier 

Editor, The Canadian 

Nurse Virginia A. Lindabury 

Editor, L'infirmiere 

canadienne Claire Bigue 



January 1969 




6 8 86 



The 






Canadian 

Nurse 





countdown to congress 



the medical assistant 



revascularization surg 








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The emphasis is on the principles of good nutrition, and 
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Concise and patient-oriented, this text offers common- 
sense guidance and specific suggestions for action in the 
key areas of pediatric nursing. The child's reaction to 
illness is stressed. 
573 Pages Illustrated 1967 Paper, $5.60 Cloth, $8.00 

A Textbook of 
Patient Care 

By Alice M. Robinson, R.N. M.S. 
The aide's role and function in the care of the mentally 
ill are realistically described. Rather than technics, atti- 
tudes toward patients are emphasized. 
226 Pages 3rd Ed. 1964 Illust. Paper, $3.25 



8 THE PSYCHIATRIC AIDE: 



9 FUNDAMENTALS OF NURSING: 

The Humanities and the Sciences in 
Nursing 

By Elinor V. Fuerst, R.N., M.A.; and LuVerne 
Wolff, R.N., M.A. 

A problem-solving approach to the principles underlying 
all nursing action, emphasizing the "core" content common 
to every area of practice. 

New Ed. in preparation 



n Payment enclosed 



n Charge and bill me 



T 



Lippincott 




2 THE CANADIAN NURSE 



JANUARY 196' 



The 

Canadian 
Nurse 



^ 

'^^ 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 65, Number 1 



January 1%9 



26 Countdown to Congress L. Graham 

i 
28 The Value of Revascularization Surgery A. Vineberg 

32 Advances in Surgery for Coronary Artery Disease A.S. Trimble 

35 Nursing the Patient After Heart Surgery J.R. Wass 

38 A New Category of Health Worker for Canada? C. Hacker 

44 Idea Exchange 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

7 News 

1 8 Names 

20 Dates 

22 New Products 



24 In a Capsule 

46 Research Abstracts 

49 Books 

52 Films 

52 Accession List 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editors: Glennis N. Zilm • Loral A. Graham 

• Circulation Manager: Berjl Darling • 
Advertising Manager: Ruth H. Baumel • 
Subscription Rates: Canada: One Year, 
$4.50; two years, S8.00. Foreign: One 
Year, $5.00; two years, $9.00. Single copies: 
50 cents each. Make cheques or money orders 
payable to the Canadian Nurses' Association. 

• Change of Address: Four weeks' notice; the 
old address as well as the new are necessary, 
together with registration number in a provin- 
cial nurses' association, where applicable. Not 
responsible for journals lost in mail due to 
errors in address. 

® Canadian Nurses' Association 1969. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
.Authorized as Second-Class Mail by the Post 
Office Department. Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway. 
Ottawa 4, Ontario. 



lANUARY 1969 



In recent months, rumblings about 
"physicians' assistants" have been 
reverberating across the country. At a 
medical meeting in Toronto in 
September, a well-known medical 
educator spoke strongly in favor of 
setting up programs for physicians' 
assistants in Canada; an equally well- 
known medical educator stood up and 
disagreed with this proposal. The 
subject is being written about and 
discussed with fervor by doctors, most 
of whom have strong opinions one 
way or the other. Nurses should 
become interested in this controversy, 
mainly because the creation of this 
category of health worker would affect 
patient care as well as the nurses' role 
in providing this care. 

The physicians' assistant role was 
created in the U.S.A. to bridge "the 
professional gap" between nursing and 
medicine and to relieve harassed 
doctors of much of their routine work. 
Does it logically follow that because 
this is good for the U.S. (and this is 
questionable) it is good for Canada? 

The answer is "no." What is needed 
in Canada is more dialogue between 
the medical and nursing professions to 
find other ways of filling any present 

"gap" 

It is the patient who will suffer if 
another category of health worker is 
added to the 50 existing ones. As the 
editor of the American Journal of 
Nursing pointed out in a July 1967 
editorial on the subject of physicians' 
assistants, "The present multiplicity of 
professional health workers — each 
prepared to fulfill the specific functions 
of his euphemistically designated 
specialty — has already clouded and 
confused the scene beyond the 
comprehension of most health workers, 
not to mention the patient." 

This month we present an article 
based on interviews of several doctors 
and nurses who hold opposite views 
about the value of the physicians' 
assistants (p.38). We agree with those 
who believe that there is no need for 
such workers in Canada. 

As Dr. A.L. Chute, dean of 
medicine at University of Toronto, says 
in this interview: "I don't think there's 
any necessity for creating a new breed 
of cats." — V.A.L. 

THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Widen your horizons 

I would like to thank you for Joyce Irwin's 
article in the July issue "Widen Your Hori- 
zons." 

The public library that I attend was very 
helpful and provided me with some wonderful 
summer reading. So far, I have read eight of the 
books mentioned in the article and found all of 
them very interesting. There are still a few 
mentioned in the article that I would like to 
read, especially the ones by Monica Dickens. - 
Esther V. Repol, Scarborough, Ont. 



ICN Congress 

I am writing to you in regard to the 
Congress of the International Council of Nurses 
to be held in Montreal in June 1969. 

Five students from our hospital, myself 
among them, attended the Canadian Nurses' 
Association convention in Saskatoon last 
summer. All of us who attended now realize the 
value that these conventions hold both for 
students and graduate nurses. 

We have the good fortune of being close at 
hand for the 1969 convention but would like to 
aid those who will have difficulty raising funds 
to attend. 

Could you give me any information about 
student nurses who would like to attend the 
convention but cannot raise the funds? Our 
student council would like to supply transport- 
ation, lodging, and convention expenses for a 
student (or more than one, depending on costs) 
who could not otherwise come to Montreal. - 
Linda G. Carter, Montreal. 



I understand that some nurses coming 
fiom abroad for the International Council of 
Nurses' Quadrennial Congress will have to find 
accommodation at the lowest available prices. 
A few of my friends and myself would be ready 
to offer rooms without charge to these col- 
leagues. - Pierrette Delage, Montreal 

These letters have been brought to the atten- 
tion of the Congress coordinator at CNA 
House. The editors. 

We would appreciate receiving as soon as 
possible requests from any provincial associa- 
tions or other groups who wish to schedule a 
private cocktail reception or dinner during the 
International Council of Nurses Congress to be 
held June 22-28, 1969 in Montreal 

We have blocked a number of salons in the 
Queen EUzabeth and Bonaventure Hotels, but 
cannot hold these rooms too much longer if we 
do not receive specific requests for reservations. 

Please write; Convention Division, Panex 
Inc., Place Bonaventure, Montreal 3. - (Mrs.) 
Laila Chisnell, Congress Coordinator, Montreal 
4 THE CANADIAN NURSE 



Office Nurse 

As a practicing office nurse one year 
removed from active hospital nursing, I agree 
wholeheartedly with Miss Christie in her article 
"Girl Friday, R.N." (Nov. 1968). However, I 
also believe that the R.N. in the office can be 
much more than an extremely competent 
medical secretary. 

In my office, which specializes in obstetrics 
and gynecology, I am being used far more 
effectively as a nurse because 1 spend all the 
time allotted for office visits with the patients. 
During this time I am able to teach general 
health rules to individual patients and to their 
famUies, fulfil my duties related to physical and 
lab procedures and explanations of special 
treatments, and gather information about the 
patient's history so that the doctor can use his 
time with the patient more efficiently. 

In this manner the doctor and I work as a 
team to help patients understand and solve 
their problems, thereby giving good medical 
care, both mental and physical, to the patient. 
- Mary Ann Cutler, Reg.N., Hamilton, Ont. 

Smug disrespect toward doctors 

An article and two letters published recently 
in THE CANADIAN NLTRSE have brought into 
sharp and uncomplimentary focus questionable 
nursing attitudes I have observed during the 
past seven years. The article was "A doctor 
looks at nursing education" (July. 196&) by 
S.C. Robinson, M.D. The two letters were both 
in the October issue - Albert Wedgery's letter 
headed "Tug-of-war attitude" and Marie 
Martin's "Incompetent interviewers." 

I believe that there is a great lack of com- 
munication not only between doctors and 
nurses, but also between nurses and nurses, and 
between nurses and patients. 1 contend that this 
lack of communication stems at least in part 
from disparaging and often ignorant attitudes 
adopted by many nurses toward non-nurses. 

Doctors have been too tolerant of sloppy 
nursing habits, although not unaware of them. 
They have been too ready to accept re- 
sponsibihty for nurses' shortcomings as well as 
their own and in so doing have allowed nurses 
to assume airs of inflated self-importance for 
pseudocapabilities. 

Mr. Wedgery echoes Dr Robinson's views 
when he writes "... we need immediate and 
listing dialogue so that nursing does not con- 
tinue to get further away from medicine. I 
suspect that this breach has resulted because 
doctors as a group have not been concerned 
about the developments in nursing education 
and the changes in nursing practice." 

Dr. Robinson writes "This, (the breach in 
dialogue) 1 believe, is the fault of the medical 
profession." 

Not entirely. I believe that Dr. Robinson has 



been far too generous in absolving nurses from 
a healthy share of the blame. 

In my experience, most doctors regard 
nurses with a great deal of respect as individuals 
and as members of the health team. Almost all 
doctors are not merely willing but eager to 
instruct and inform in any area of patient care 
when the nurse displays an interest. 

Mr. Wedgery asks "... how often and in 
what manner have doctors communicated with 
nurses as members of the team? " I ask, how 
often and in what manner have nurses sought 
communication with doctors as members of the 
team and been rejected? 

Conversely, 1 have encountered in nurses at 
all levels an incredible degree of smug disrespect 
toward doctors, albeit hypocritically concealed 
from the physician behind a pretentious mask 
of servitude. 

This is clearly evidenced not only in remarks 
by staff nurses in dressing rooms, such as "Old 
flint-face doesn't need half the instruments he 
asks for" but more appallingly, in direct 
comments by nurse interviewers. For example: 
"We really aren't interested in what the doctors 
have to say; what we want is a record from the 
nursing office or a report from a director of 
nursing." 

Does the nurse interviewer assume that the 
director of nursing from her office can better 
assess the nurse's capabilities than the surgeon 
to whom she passes the instruments? Yet, as 
Marie Martin points out in her letter "These 
same persons admit they have no idea . . . what 
type of procedure is carried out for any con- 
dition." 

Today, "reassurance" to the patient too 
often consists of "Don't worry, Mr. Jones; you 
just relax and everything will be alright." 

The nurse is not insincere in her attempts to 
give reassurance; .she is simply thoughtless. She 
finds it difficult, or doesn't attempt, to picture 
the patient out of the context of the hospital 
environment and his illness. She doesn't 
imagine him as a well social being making con- 
tributions as necessary to society as her own. 

For example, his time is just as valuable as 
her own. But nurses - and doctors - seem to 
lose sight of this, as can be observed day and 
night in the outpatient and emergency depart- 
ments of most large hospitals, where patients 
with comparatively minor ailments are forced 
to await treatment for anywhere from two to 
six hours. Though I don't believe that the main 
fault here lies with the nurses, I do think they 
could display a little awareness and sympathy 
for the inconvenience imposed upon the 
person. 

After waiting two hours, a friend of mine 
politely asked how much longer the wait might 
be, thinking she might pass part of the interval 
having coffee. "If you don't want to wait you 

JANUARY 1%9' 




can come back tomorrow," retorted the nurse. 

It is important to be aware of the psy- 
chological changes occurring in a person who is 
sick; but it is also important to realize that the 
person is not always sick and that even when he 
is sick the changes are not total and his personal 
integrity remains. 

If nurses sincerely wish to attain Mr. 
Wedgery's goal of "a truly professional nursing 
service to the public," then they might well 
become acquainted with the fact that the 
public is people, not merely patients. - Carole 
Stafford, Reg. N., Toronto. 

Stand up and be counted 

Re the vis-a-vis about a paid provincial pre- 
sident (August 1968): I wholeheartedly say 
"yes." 

It is most refreshing to hear Monica Angus' 
point of view, in which she urges the bedside 
nurse to take a more active part in decisions 
affecting the welfare of patients, and the 
working conditions and salaries of nurses. 

I am told that there is a fresh wind blowing 
in nursing, which is long overdue. We must 
participate at the local level and stand up to be 
counted. - Berta Schmidt, R.N., Cert. P.H.N., 
Victoria, B.C. 

Why can't the CNA ? 

At the request of the editorial staff of THE 
CANADIAN NURSE 1 attended the Registered 
Nurses' Association of Ontario regional confe- 
rence on the use of audiovisual aids in nursing 
held in Toronto from November 1 1 to Novem- 
ber 14. I had not seen the latest issues of the 
magazine, nor received any special briefing. 

Toward the end of the first day, a few ques- 
tions occurred to me; I understand that some of 
them were also asked in an editorial in the 
October issue (page 33). Throughout the con- 
ference, delegates kept asking me what the 
Canadian Nurses' Association was doing in cer- 
tain areas. On my return to Ottawa, I found out 
that as often as not, nothing was being done. 

The first speaker was David Clee, professor 
of education in charge of the Educational 
Media Center at the College of Education, Uni- 
versity of Toronto. He told how teaching has 
turned away from the didactic, rote-learning 
approach to that of teaching through dialogue 
and the enquiry method, using techniques in 
which the student is the center of the curri- 
culum and emphasis is on the learning process. 

The lectures and discussion periods that 
followed pinpointed several problems: 

1. Older teachers, used to the authoritarian 
approach, feel useless and frustrated when they 
are faced with a classroom made up of discuss- 
ing, questioning groups, rather than a block of 
listening students. There is a need for special 
training of these teachers. 

2. Many teachers do not know how to use 
equipment and are afraid to experiment with it. 
As Lou Wise, assistant director. Visual Aids 
Department, Toronto Board of Education - 
JANUARY 1969 



the second speaker - pointed out, the use of 
media no longer means ordering the odd 16mm. 
film and showing a few slides. In Toronto, 
workshops have been held for the past eight 
years showing teachers how to make 8mm. 
movies for use in highschools, and students are 
participating. The Toronto School Board's 
Teaching Aid Service supplies technicians for 
servicing equipment and helping and advising 
teachers; they hope to have such a technician in 
all pubUc and separate schools in the city.. 

Mr. Wise forecast the establishment of a 
16mm. film-production center for all the 
nursing schools in Ontario. 

3. For the last two or three years, nursing 
teachers have been producing their own 8 mm. 
films. They have begun to reahze that there is 
much duplication of effort and that there is a 
need for centralization for purposes of exchan- 
ges. As a matter of fact, the RNAO set up this 
series of conferences on audiovisual aids 
because a voluntary group of nursing school 
teachers wanted to pool their resources to set 
up a central agency for auxiliary teaching aids. 
When this group approached the RNAO last 
fall, RNAO decided that the need was shared 
by the province, and organized the conferences 
on audiovisual aids. Through the RNAO, this 
group of nursing teachers presented a brief in 
April 1968 to the Ontario Council of Health, 
asking for funds to pay the salary of a person 
who would assess the audiovisual needs in the 
province. This brief has already been studied by 
subcommittees, and is expected to go before 
the council itself any day now. 

This need cannot be just province-wide. 
What is beeing done in other provinces? Should 
not the CNA act as a coordinating body? (I 
asked one of the members of the RNAO plan- 
ning committee whether she thought that the, 
CNA should be handling a project of this nature 
and the comment was, "They don't seem to 
have the money and if fees were raised again, 
there would be a howL The need is urgent; we 
have to do something now; we can't wait for 
CNA.") The RNAO is supposedly short of 
money also; if they can find a means of raising 
funds, why can't the CNA? 

There was unanimous condemnation of 
Trainex film strips, as well as of some other 
commercially provided visual aids such as slides, 
because of the gross errors of technique de- 
picted. This points out the need for the esta- 
blishment of a committee, or at least the 
appointment of one person to provide consul- 
tative services to commercial companies. This 
person or committee could also advise the 
textbook companies almost all of which are 
now putting out slide series to accompany their 
nursing textbooks. The speakers and the dele- 
gates unanimously felt that many of the com- 
mercial sUdes, though accurate and well produ- 
ced, were unsuitable for their teaching needs. 

4. Library services: As I mentioned, 
textbook companies are now providing slides to 
accompany books. Is there any reason that 
these slides should not be available in the same 
place as the textbooks? Many high school 
libraries (and not only in the main cities - one 
of the delegates from a small northern town 
said the system was in use there in grade se- 



ven! ) offer study carrels in which students can 
view slides, 8mm. films, and other material; the 
equipment is supplied by the library. I met one 
nursing school librarian who is setting up a 
five-year plan for the incorporation of audiovi- 
suals; she is thinking of putting teaching aids 
such as transparencies in the same section as 
textbooks on the subject. 

5. Barbara Smith, Coordinator of Libraries 
of the Board of Education for the town of 
Mississauga talked about "Preparing for Infor- 
mation Service in your Future." She pointed 
out that already the services offered by many 
libraries include: 

- Computerized information retrieval and 
bibliographical control (computers indicate 
whether book is in library and, if not, when it is 
to be returned; all records of the library are 
made available. Dial access to films, tapes, 
records, etc. (You sit in the carrel, dial for the 
necessary film and see and hear it in the carrel). 

Facsimile transmission of hard copy 
through the telephone (printed text is actually 
reproduced before you). 

On-line computer terminals (these look like 
typewriters; they are linked to a main library 
where a computer prints information on the 
typewriter-like machine in front of you). 

Miss Smith said that centraUzation and 
cooperation are necessary if we are to harness 
the large amount of information that we are 
deluged with constantly. Committees are 
necessary to evaluate materials so that what is 
produced can be either shared or reproduced. 
Decisions dealing with information storage and 
retrieval should be made with automation in 
mind. This could save millions of dollars. Miss 
Smith mentioned a computerized central me- 
dical library in Washington; is it not Ukely that 
a central computerized library will be necessary 
in Canada in the not-so-distant future, and 
should not the CNA start to plan for it? 

6. Other questions regarding CNA that were 
put to me at the conference include: "Is there a 
quick reference guide to evening classes and 
other classes given in nursing schools across 
Canada? " and "Do you have any French books 
in your library? I don't remember having seen 
any." 

This brings up another major issue. When 
plans are being made to introduce audiovisual 
aids and other forms of automation, should not 
provision be made at the very beginning to have 
biUngual services? For example, if you are 
planning to have transparencies, overlays should 
be provided in both languages; soundtracks also 
should be in both languages. When shdes or 
other materials are ordered from a commercial 
source, attemps should be made to obtain the 
text in French: you will notice that more and 
more commercial audiovisual aids are made 
available in both languages. 

The CNA is a national association; it is 
incredible that of its professional staff, only the 
editors of L 'infirmiire canadienne speak fluent 
French. When the association plans to intro- 
duce changes made necessary by automation, 
should it not without hesitation hire additional 
professional staff that is bilingual? - Ramona 
Macdonald, former assistant editor, L 'infirmiire 
canadienne. CI 

THE CANADIAN NURSE 5 




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the modern, disposable micro-enema! 







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easier to carry, use, store. 

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minutes. No preparation. No after-use handling. 

Microlax is easier on patients, too. Even for post- 
operatives and children. Acts fast (5 to 20 minutes). 



Microlax costs less than any other disposable enenna! 

6 THE CANADIAN NURSE 



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110 Place Cremazie, Suite 412, 
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lANUARY 1%9 



news 



Canadian Elected Chairman 
Of PAHO Nursing Committee 

Washington, D.C. - A Canadian nurse has 
been elected chairman of a newly-formed 
committee that advises the Pan American 
Health Organization on ways and means of 
developing its nursing program in Latin Ameri- 
ca. 

She is Dr. Helen K. Mussallem. executive 
director of the Canadian Nurses' Association. 
Ottawa. She was elected chairman of the first 
meeting of the P.AHO Technical Advisory 
Committee on Nursing. The seven-member, 
international group is made up of experts from 
Brazil. Canada. Chile, Colombia, Mexico, 
Panama, and the United States. 

The ratio of nursing personnel for Canada 
an the United States, according to PAHO figu- 
res, is 2.2 nurses and 2.6 nursing auxiliaries for 
every physician. It is 0.7 and 1.6 respectively 
for the countries of Middle America, and 0.4 
and 1.1 respectively for those of South Ameri- 
ca. Thus, a major item for discussion was the 
type of program Latin American countries 
might develop to alleviate the nursing shortage, 
rated the area's most serious health-personnel 
problem. How a country can best put its nurses 
to work in the care of patients was another 
item on the agenda, as was the education of 
university trained nurses, and of nursing 
auxiliaries. 

CCUSN Elects Executive 

Ottawa, Ont. - The executive officers of 
the Canadian Conference of University Schools 
of Nursing were named at a meeting of CCUSN 
Council held in Ottawa. November 5 to 7, 1968. 
Margaret MacPhedran, director of the School of 
Nursing. University of New Brunswick, was 
named President. 

Sister Jean Eudes, Mount St. Vincent Uni- 
versity, is first vice-president. Jean Godard, 
McGill University, is secretary, and Carolyn 
Pepler, University of New Brunswick, is trea- 
surer. Margaret Hart, University of Manitoba, is 
past-president. 

Regional advisors are: Margaret Bradley, 
Dalhousie University, for the Atlantic region; 
Sister Marie Bonin, University of Montreal, for 
the Quebec region; Marion Woodside, Univer- 
sity of Toronto, for the Ontario region; and 
Ahce Baumgart, University of British Columbia, 
for the Western region. 

The CCUSN Council, which consists of the 
deans and directors of the 21 university schools 
of nursing plus two representatives from each 
ot the four regions, was meeting concurrently 
with the Association of Universities and 
Colleges of Canada (AUCC). 

CCUSN is an organization of university 
schools of nursing in Canada and has existed 
since 1942. This summer at its annual meeting 
JANUARY 1%9 



Well-Known Speakers To Address ICN 



Ottawa. - Many well-known persons from 
every corner of the globe will address the ple- 
nary sessions at the 14th Quadrennial Congress 
of the International Council of Nurses in Mont- 
real, June 22-28, 1969. The Canadian Nurses' 
Association's coordinator with the ICN Con- 
gress Committee, Harriet J.T. Sloan, told CNA 
staff in December that most Congress speakers 
have now been obtained. 

Lester B. Pearson, former prime minister of 
Canada, will speak at the first plenary session 
on Wednesday, June 25. The topic of this 
morning session is Forecasting The Future, and 
Mr. Pearson will discuss the cultural, social, and 
economic factors that will affect nursing. Chair- 
man of the morning's session will be Mile Alice 
Clamageran, of France, first vice-president, 
ICN. 

Other speakers at the first plenary session 
include: Dr. J.D. Wallace, executive director, 
Toronto General Hospital, and Miss N.K. 
Lamond, South Africa. Their sub-topic is 
"Technological Change in Nursing." Miss Lucy 
Germain, assistant director, Pennsylvania 
Hospital, Philadelphia, USA, will then discuss 
"Technological Change in Administration." 

Implications of Change is the topic of the 
afternoon plenary session on Wednesday, June 
25. Chairman Mrs. K. Pratt, Nigeria, third vice- 
president. ICN, will introduce the speakers, 
who are: M. Claude TeHier. a Montreal barris- 
ter, and Miss J. Sotejo, dean of nursing. Univer- 
sity of the Philippines. Their sub-topic is 
"Technological Change and the Law." Dr. Leo 
A. Dorais, director of permanent education. 
University of Montreal, and Miss Nelly Garzon, 
faculty. National University of Columbia, 
Bogota, Columbia, South America, will speak 
on "Technological Change and Human Rela- 
tions." 

Thursday morning's plenary session. Educa- 
tion for Today and Tomorrow: Basic Programs, 
will be chaired by CNA President Sister Mary 
Felicitas. Speakers and their topics are: Dr. 
Phihppe Garigue, dean, faculty of social 
sciences. University of Montreal: "Patient and 
Family-Centered Care"; Miss Ingrid Hamelin, 
Finland: "Program Patterns in Basic Nursing 
Education"; Miss Florence Mackenzie, director 
of nursing education. The Montreal General 
Hospital: "The Hospital School in Canada"; 
and Dr. Mildred Montag, professor of nursing 
education. Teachers College, Columbia Univer- 
sity, N.Y.: "The Junior College Program in the 
U.S.A." 

Later on Thursday morning, a panel will 
discuss "The Basic Program at the University 
Level." Panelists include: Dr. Rozella Schlo- 
tfeldt, U.S.A.; Miss Sheila CoHins, U.K.: Miss T. 




INTERNATIONAL 

COUNCIL OF NURSES 

T4lh QUADRENNIAL 

CONGRESS 1969 

MONTREAL CANADA 



^P 



CONSEIL INTERNATIONAL 
DES INFIRMIERES 
XIVcCDNGRES 
QUADRIENNAL 1969 
MONTREAL CANADA 




Agah, Iran; Miss M. Kaneko. Japan; and Mr. 
M.A. .Ahad. India. 

The plenary session on Thursday afternoon 
will be chaired by Miss E. Louise Miner. CNA 
president-elect. The topic is Education for 
Today and Tomorrow: Post-Basic and Post- 
graduate Programs. Mile Jane Martin. France, 
will speak about 'Aims for Tomorrow." A 
panel discussion about "Teaching Tomorrow's 
Nurses" will be chaired by Dr. Gerald Nason 
president of the Canadian Teachers' Federation. 
Panelists include: Miss B. Salmon. New 
Zealand; Miss W. Hector. U.K.; Mile J. Demau- 
rex, Switzerland. 

Speakers at Friday morning's plenary 
session include: Gilles Paquet, Carleton Univer- 
sity, Ottawa, who will discuss "Health Care 
Economics"; Bernard Blishen, dean, graduate 
studies, Trent University, whose topic is 
"Socialized Medicine or Not? "; Miss E. Cant- 
well, U.S.A., who will discuss "The Nurse- 
Personal Security"; and Mrs. G. Zetterstrom 
Lagervall, Sweden, who will talk about "The 
Professional Association and Economic Secu- 
rity for the Nurse." 

Dr. Robert Merton. the well-known U.S. 
sociologist, is the first speaker at the Friday 
afternoon session, which will be chaired by Miss 
Ruth Elster, Germany, second vice-president, 
ICN. Under the topic Leadership in Action, Dr. 
Merton will discuss "The Nature of 
Leadership." He will be followed by Miss J.C. 
Rodmell, Australia, and Miss Antje Grauham, 
Germany, who will discuss "Leadership and the 
Administrative Process" and "Education for 
Leadership" respectively. 

The two final speakers on Friday are: Mrs. 
Jytte Kiaer, Denmark, who will speak about 
"Leadership for Technological Advance in 
Nursing"; and Professor Charlotte Searle, South 
Africa, who will discuss "Leadership in the 
Nursing Context of Tomorrow." 

The ICN governing body, the Council of 
National Representatives, meets Monday and 
Tuesday, June 23 and 24, All Congress 
participants are invited to attend these sessions 
as observers. 



THE CANADIAN NURSE 7 



Special 
offer to CN A 

members 



/ # 



"The Leaf and The Lamp' 

CNA's Diamond Anniversary Publication 



The Canadian Nurses' Association proudly 
announces that its 60th anniversary publication. 
The Leaf and The Lamp, will be available in 
mid-May. 

An overview of the first 60 years of the CNA, 
The Leaf and The Lamp brings quickly into focus 
Canadian nursing as it is today, and will be 
tomorrow; then dips back into history for a review 
of the origins, beginnings and highlights of the 
profession in Canada. 

It is a fact-filled book that will be a handy 
reference. The Leaf and The Lamp is a must for the 
bookshelf of every nurse — student, active or 
retired — and for everyone interested in nursing 
and its future. 



Advance Offer— $2.50 per copy 

A pre-publication offer enables you to order the book now at 
$2.50 per copy. Be among the first in Canada to obtain a copy of 
the first press run of this important document. 



To: Canadian Nurses' Association 

50 The Driveway, Ottawa 4, Ontario 

Please send me (No. of copies) 

of The Leaf and The Lamp 

at the pre-publication price of $2.50 per copy. 

I enclose a cheque D or money order D 

NAME 

ADDRESS 

Present position 

Registration No 



TheLeaf 

^eLamp 

/ 



i 



^-A^, 



"""-N, 



"»«ts' 



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8 THE CANADIAN NURSE 



JANUARY 1%9 



news 



it radically changed the structure of the Confe- 
rence in an effort to take a stronger and more 
active role in higher education for nurses. 

OHSC Raises Bonus Rates 
For Service Personnel; 
Teachers' Bonuses Remain Same 

Toronto. — The Ontario Hospital Services 
Commission has agreed to raise the bonuses to 
university-trained nursing service personnel and 
not to lower the bonus paid to university- 
trained teachers of nursing. The OHSC had 
previously suggested that salary bonuses paid 
for university educational preparation should 
be equal for nursing service personnel and 
nursing education personnel, but wanted to 
equalize the two by lowering the teachers' 
rates. 

The new rates for both service and educa- 
tion personnel are $40.00 a month for one-year 
university preparation, $80.00 a month for 
bachelor's preparation, and $120.00 a month 
for master's preparation. This is the same rate 
that has been given to teachers for the past 
three years. 

The service personnel rates were raised from 
a $25.00/$55.00/$100.00 scale. 

The new rates were put forward at a 
meeting of representatives from the Ontario 
Hospital Association, the Ontario Hospital 
Services Commission, and the Registered 
Nurses' Association of Ontario. 

The rates are lower than those recommend- 
ed by the Registered Nurses' Association of 
Ontario. However an RNAO spokeman said 
that the organization was satisfied with the new 
rate. 

CEGEP System Explained 
At ANPQ General Meeting 

Montreal - The operation of the Colleges 
d'enseignement general et professionel was the 
topic of a speech given by Therese D'Aoust to 
the general meeting of the Association of 
Nurses of the Province of Quebec. The meeting 
was held in Montreal October 31 to November 
1. 

CEGEP colleges offering nursing have in- 
creased from 12 in 1967 to 20 in 1968. Dawson 
College in Montreal is expected to open the 
first English-language school in September, 
1969. 

Miss D'Aoust explained that there is only 
one category of instructor within the system, 
responsible for theory, clinical teaching, clinical 
programs, supervision of cUnical orientation, 
clinical evaluation, laboratory sessions in 
nursing care, and evaluation of nursing care 
demonstratidns. 

Rita Lussier, of the Quebec Hospital Asso- 
ciation, questioned Miss D'Aoust about the one 
category of instructor, saying that a nurse 
seldom has experience in all fields. Miss 
D'Aoust pointed out that the instructor would 
be responsible for only one field of nursing 
care. 

JANUARY 1%9 




Two members of The Montreal General Hospital Alumnae Association examine a 
collection of nurses' uniforms, caps, and other mementos representing the years 
between 1915 and 1960. The Ottawa branch of the alumnae association donated 
the display to the Archives of the Canadian Nurses' Association, Ottawa On the 
left is Miss Grace Tanner, sister of the founder of the alumnae association; on the 
right is Miss Jean Kerr, who at 97 is the oldest living graduate of The Montreal 
General Hospital Photo was taken in the CNA library. 



Qualifications of instructors in the CEGEP 
system are: a master's degree for directors, and 
a baccalaureate degree for instructors. Preferen- 
ce is given to those who held positions in 
hospital schools of nursing. An experienced 
nurse without the required qualifications, but 
with an outstanding ability to communicate 
would be considered. Opportunities are 
provided for instructors to improve their quali- 
fications within the system. 



RNAO Holds Regional 
Conferences On Audiovisual Aids 

Toronto. - "Today's child is in an image- 
structured, not a print-structured world, busi- 
ness is 25 years ahead of education in the use of 
the media and the Church is 25 years behind 
education." This is how David Clee, professor 
of education in charge of the Educational 
Media Center at the College of Education, 
University of Toronto, explained the "why" of 
audiovisual aids in education to the 125 dele- 
gates attending the Regional Conference on 
Audiovisual Aids, sponsored by the Registered 
Nurses' Association of Ontario, held in Toron- 



to, November 11 to 14. Mr. Clee stressed the 
importance of personal qualities of the teacher 
and of non-verbal means of communication 
within the context of the new dialogue ap- 
proach in teaching: "What I'm told I forget; 
what I see, I remember; what I do, I under- 
stand." 

Lou Wise, assistant director of the Visual 
Aids Department, Toronto Board of Education, 
highlighted advances in the use of visual aids in 
the high schools in Toronto and illustrated how 
some of these aids could be used. 

Patricia Prentice, nursing instructor, school 
of nursing, Ryerson Polytechnical Institute, 
showed how slides could be prepared and used 
in nursing education. Betty Bennett, of the Quo 
Vadis School of Nursing, pointed out some of 
the ways in which tapes could help nursing 
teachers. The advantages and disadvantages of 
overhead projectors using opaque materials and 
transparencies were explained by Sylvia Mount- 
ney of the Nightingale School of Nursing. 

Heidi Yamashita, assistant director. Nightin- 
gale School of Nursing, gave a breakdown of 
the costs, equipment, and planning required for 
the production of home movies. 

THE CANADIAN NURSE 9 



What a way to start the day! 





"P*. 






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10 THE CANADIAN NURSE 



JANUARY 1%9 



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have a sure, quick, and easy method 
of preparing those hard to wrap 
items for gas sterilization? Sound 
unbelievable? Then take a look at 
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packaging material, heat-seal, trim 
and heat-seal the other end. 



For complete details see the man from C. R. BARD. He really wants to make your day better. 



INTEGRITY 




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SJANUARY 1%9 



THE CANADIAN NURSE 11 



news 

The closing speaker was Barbara Smith, 
coordinator of Ubraries, Board of Education for 
the town of Missassauga. Miss Smith stressed 
the role of libraries as service centers and 
summarized the types of services presently 
available and outlined the library services of the 
future. She also called for greater cooperation 
between experts in the fields of nursing educ- 
ation and information science. 

The lectures were supplemented by question 
and discussion periods as well as demons- 
trations. 

ICN Congress Registration 
Continues To Lag 

Ottawa. - To date, only 219 Canadian re- 
gistered nurses and 1 1 Canadian nursing stu- 
dents have registered for the 14th Quadrennial 
Congress of the International Council of Nurses 
to be held in Montreal June 22-28, 1969. "We 
are somewhat concerned about this slow regis- 
tration," Harriet J.T. Sloan, the Canadian 
Nurses' Association's coordinator for the ICN 
Congress Committee, told CNA staff at a 
December meeting, "as it is most essential that 
there are sufficient Canadian nurses to act as 
hostesses for our international guests." Miss 
Sloan pointed out that 2,822 of the 6,213 
registrants (45.4 percent) at the ICN Congress in 
Montreal in 1929 were Canadian. 

The Congress, which begins on Sunday, 
June 22, with an Interfaith Meeting at Notre- 
Dame Cathedral, is expected to attract over 
12,000 nurses from all over the world. As of 
December 6, registration of foreign nurses was 
400. 

The ICN Congress registration fee is $40 if 
received by CNA before January 22. Late re- 
gistrations will be accepted, but the fee will be 
$60 after that date. 

Student registrants are welcome to attend 
all sessions of the Congress, including the color- 
ful opening ceremonies on Sunday, June 22. 
Two hundred students from Canada are allowed 
to register. Applications will be processed on a 
first-come, first-served basis. 



Schools Evaluate Tests 
As Educational Aids 

London, Ont. - "Testing: Frustration or 
Facilitation" was the theme of the workshop 
held on November 8 and 9, 1968 in Holdsworth 
Auditorium, Victoria Hospital, London, School 
of Nursing. The program, which was planned as 
an inservice project for the combined faculties 
of St. Joseph's Regional School of Nursing and 
the Victoria Hospital School of Nursing was 
attended by 70 teachers. 

Dr. Josephine Flaherty, a specialist in the 
field of evaluation and testing, shared ideas 
from her experience and research. Group 
discussions provided an opportunity for the 
exchange of ideas and concerns encountered in 
evaluating nursing students. 

12 THE CANADIAN NURSE 




Ottawa. - The Nurses' Alumnae Association of the Ottawa General Hospital and of the Univer- 
sity of Ottawa School of Nursing, held its first Memorial Tribute Service to Canadian Nurses 
before the Nurses' Memorial, Hall of Honor, Parliament Hill, on November 10. 
Margaret Olsiak (right), president of the Alumnae Association, presented a wreath on behalf of 
her Association. Margaret D. McLean, second vice-president of the Canadian Nurses' Asso- 
ciation, represented CNA at the Service. She addressed the assembly and placed a floral tribute 
before the Memorial. 

Shown with Miss MacLean and Miss Olsiak are Rosario Gendron (left), parliamentary secretary 
to Health Minister John Munro, and Father Paul-Emile Sanschagrin, University Chaplain. 



United Nurses Of Montreal 
Hold Second Annual Meeting 

Montreal- The second annual meeting of 
the United Nurses of Montreal took place 
Friday evening, November 29, in the audito- 
rium of the Royal Bank Building, Place Ville 
Marie. 

The United Nurses of Montreal is a union of 
Professional nurses formed in 1966 by the 
EngUsh Chapter, District XI of the Association 
of Nurses of the Province of Quebec. 

It represents 3,000 nurses in 21 English- 
speaking hospitals on the island of Montreal, as 
well as nursing personnel in the Northern 
Electric Company, the Protestant School Board 
of Greater Montreal, the City of Westmount, 
the Victorian Order of Nurses (Greater 
Montreal, Lachine-Dorval and Ste Anne de 
Bellevue branches), the Children's Service 
Center and Child Health Association. 

Presented by Wendy D. Rogers, president, 
on behalf of the executive and board of direc- 
tors, the report covered the union's activities 
from November 1, 1967 to October 31, 1968 
for both the general membership and the asso- 
ciate group. 

Among the subjects Mrs. Rogers summa- 
rized were the number of contracts signed, 
progress of negotiations, finances, education 
and future plans. 



Particular emphasis in the report was given 
to the union's efforts to teach member nurses 
the significance^of the clauses in the contracts 
and their importance to them as individuals and 
to the profession. This was done through orga- 
nized workshops and UNM councillors. 

She also dealt with the progress of the 
publicity, health insurance, pension plan, and 
financial committees. One of the union's 
greatest achievements, stressed Mrs. Rogers, was 
the formation of the Joint Committee on 
Nursing. This committee is made up of five 
members of the UNM, representing various 
levels in the nursing profession, and of five 
administrators, representing the administration 
of Enghsh-speaking hospitals in Montreal It has 
been working on a definition of the role of the 
nurse and will continue working out definitions 
of the different categories of nurses and of 
nursing itself. 

Tribute was paid to executive secretary 
Margaret K. Stead. Mrs. Rogers said that Miss 
Stead's knowledge of labor relations and her 
expert guidance through negotiations had been 
invaluable assets to UNM. Mrs. Rogers was also 
gratified to note that the UNM had become 
involved in government and professional activi- 
ties. For example, last March it was invited to 
send a representative to the meetings on the 
Superior Council of Nursing, a government 

JANUARY 196S 




committee under the Minister of Health, which 
studies, among other subjects, the workload of 
nuises. 

The UNM is also a member of the advisory 
committee set up by the Department of Educa- 
tion for the CEGEPs, under which system 
nuises in the diploma course will be trained in 
Quebec in the future. 

Mrs. Rogers mentioned the union's fruitful 
association with SPIQ, (Syndicat Professionnel 
des Infirmieres du Quebec), a union of 3,000 
nurses located chiefly in hospitals in Quebec 
City and centers throughout the province. 

Together, SPIQ and UNM represent more 
than 6,000 nurses, the largest group of unioni- 
zed nurses in the province. 

The two unions present their contracts 
together to the Association of Hospitals of 
Quebec and the Department of HeaHh. 

Negotiations commenced last April and 
meetings take place regularly, reported Mrs. 
Rogers. To date, a number of nonmonetary 
clauses has been settled satisfactorily. Plans for 
the future include restructuring the constitu- 
tion of the UNM to provide for an enlarged 
membership. 

Copies Of Speeches Requested 
So Requested Speeches Copied 

Ottawa. - So many requests have been 
received for copies of the papers presented at 
the clinical sessions held during the Biennial 
Convention of the Canadian Nurses' Asso- 
ciation in July that the Association has decided 
to publish them. 

Valerie Foumier, CNA Public Relations 
Officer, has announced that the papers will be 
presented in mimeographed form in a single 
volume. The cost will be $2.50. 

Not all the papers are presented, as some 
speakers did not supply copies of their 
speeches. However, the volume contains those 
papers from the sessions on nurses and the 
practice of nursing, continuity of patient care, 
Canadian testing service, clinical fields in 
nursing education, and clinical research in 
nursing. 

NBARN Organizes 

For Collective Bargaining 

Fredericton. - The Provincial Collective 
Bargaining Committee of the New Brunswick 
Association of Registered Nurses met for the 
first time on November 28th and 29th, 1968. 
This historic meeting, which was held in Frede- 
ricton, was a further step in preparation for 
collective bargaining under anticipated labor 
legislation. Committee members were assisted 
by Glenna Rowsell, Consultant in Social and 
Economic Welfare of the Canadian Nurses' 
Association, Ottawa. 

The Provincial Committee will form part of 
the provincial collective bargaining structure. 
This structure was designed to function on a 
province-wide basis under the anticipated legis- 
lANUARY 1%9 



lation. The 12-member committee represents all 
nurses' staff associations in the province. 

The majority of nurses in New Brunswick 
are included under the new Public Service 
Labour Relations Bill, which has gone through 
second reading in the Legislature. This will 
provide the collective bargaining framework for 
nurses and other public servants once it is decla- 
red law. The Bill would provide a choice of 
arbitration or strike vote for public service 
employees. 

At present, New Brunswick nurses do not 
have collective bargaining rights. 



Possible Change 
In RNAO Bylaws 

Toronto. - Members of the Registered 
Nurses' Association of Ontario will be asked to 
vote on changes in the categories of member- 
ship at the Annual Meeting May 1-3, 1969. If 
accepted, the changes, which were recom- 
mended by the RNAO board of directors at its 
meeting November 22-23, would take effect in 
1970. 

Prior to 1966, there were four types of 
membership in RNAO: honorary, active, asso- 
ciate, and inactive. In 1966, the bylaw was 
changed, reducing the number of categories to 
two: honorary and regular. The present mem- 
bership fee for regular members is $35 per year. 

The RNAO board of directors recommends 
that the bylaws be changed to permit: 
9 An affiliate membership with a fee of $18. 
for the non-working nurse. If the nurse returns 
to work, she would pay a differential fee of 
$17. 

• An out-of-the-province affiliate membership 
at $12. 

• An affiliate membership with a fee of $18 
for registered nurses who are enrolled for full- 
time study at university. 

• An associate membership with a fee of $18 
for graduate, non-registered nurses who are 
members of local collective bargaining units 
recognized by RNAO under the requirements 
of the Labour Relations Act in Ontario. This 
change would be reviewed in three years. 

• Present membership in RNAO, which is 
voluntary, is approximately 13,000. 

Aspirin May Cause Ulcers. 

Chicago. - Aspirin may contribute to the 
formation of gastric ulcers, according to a 
report presented to the 54th Annual Clinical 
Congress of the American College of Surgeons 
in Atlantic City. 

Drs. Rene Menguy and Martin H. Max, of 
the Pritzker School of Medicine, University of 
Chicago, said investigation showed that aspirin 
taken orally significantly impairs the abiUty of 
cells to produce a protective mucous coating. 
Recent research with dogs has shown that 
aspirin administered so that it does not come 
into contact with the stomach lining causes an 
increased loss of cells from the lining, due to 
the action of circulating aspirin rather than 
direct contact. 

Over 20 million pounds of aspirin is consu- 
med annually in the United States. 



Haute Couture On The Wards 




MontreaL - It isn't a famous Dior or Ba- 
lanciaga model - but it looks just as good. 
The new uniform for nursing students at the 
Colleges d'enseignement general et profession- 
nel (CEGEP - Colleges of general and profes- 
sional education) was designed to be both 
practical and beautifuL 

The white, one-piece, loose-fitting, short- 
sleeve dress buttons down the left front in a 
modified "Ben Casey" style. A uniform for 
male students has a similarly shaped jacket 
worn with white trousers. 

The uniforms will be worn in all CEGEPs 
throughout the province. They have been on 
trial in three schools already and have proved 
satisfactory. 



ANPQ Committees Discuss 
Uniform Nursing Techniques 

Montreal - Two meetings of the nursing 
and education committees of District XI, of the 
Association of Nurses of the Province of 
Quebec, were held in October and September 
to establish uniform nursing techniques that 
might be applied in hospitals throughout the 
province. The meetings were intended to 
provide opportunities to analyze and develop 
the nursing techniques. 

Sister Bernadette Poirier, director of nursing 
at Notre-Dame Hospital in Montreal, spoke of 
the basic criteria of the nursing profession, the 
purpose of nursing studies, and outlined rela- 
tionships between nursing and the government. 
P. Desautels, Claudette Domingue, and Evelyn 
Adam took part in a round-table discussion 
following the talk. 

The two meetings were held at Jean Talon 
Hospital and Notre-Dame Hospital in Montreal. 
Some 225 nurses attended. 

THE CANADIAN NURSE 13 



news 



RNABC Donates $ 5,000 
To CNA For ICN Costs 

Vancouver. - The Registered Nurses' Asso- 
ciation of British Columbia donated $5,000 to 
the Canadian Nurses' Association in December 
to help defray expenses for the 14th Quadren- 
nial Congress of the International Council of 
Nurses to be held in Montreal June 22-28, 
1969. RNABC is the second province to make a 
donation. Last month the Registered Nurses' 
Association of New Brunswick donated $5,205. 

Commenting on RNABC's generous contri- 
bution, 0r. Helen K. Mussallem, CNA executive 
director, said that the gift is a most welcome 
one in view of the heavy expenses that are in- 
volved in being the hostess country. 

At least four provinces, including British 
Columbia, Ontario, Manitoba, and New Bruns- 
wick are sending their public relations officers 
to help the CNA press team at the ICN Con- 
gress. More than 100 representatives from 
nursing journals, newspapers, TV, and radio are 
expected to cover the Congress. 

Pembroke Hospital Sponsors 
Team Nursing Workshop 

Pembroke, Ont. - "There's a better way - 
find it." That is the motto Thora Kohn, an U.S. 
expert on team nursing, told 83 nurses attend- 
ing a three-day Workshop on Team Nursing 
held at the Pembroke General Hospital, Octo- 
ber 22 to 24. Mrs. Kohn is author of two books 
on team nursing. Team Nursing Leadership and 
Communication in Nursing. 

The Workshop, part of the hospital's in- 
service education program, was attended by 
nurses from six eastern Ontario centers. It 
included topics on communication, formulation 
and use of nursing care plans, team conferences, 
easy steps in team nursing, and leadership in 
team nursing. 

Dorothy Desjardin, inservice education 
coordinator at Pembroke General Hospital and 
chairman of the workshop committee, com- 
mented on the interest and eagerness of nurses 
to reorganize their methods of team nursing. 
"We would like to emphasize for the benefit of 
other nurses the advantages of team nursing and 
the fact that it can be implemented in most 
nursing unit assignments," she said. 

Lung Cancer On Rise In Canada 

Offjwa.-The death rate from the lung cancer 
epidemic plaguing Canada increased 10 percent 
between 1966 and 1967, reports the Minister of 
National Health and Welfare John Munro. The 
disease caused 4,318 deaths in 1967, up from 
3,844 in 1966. Of these deaths, 3,700 occurred 
among men, 618 among women. The rate per 
100,000 population, statistically standardized 
to the 1961 census population to allow compa- 
rison, was up for men from 32.9 in 1966 to 
36.3 in 1967. For women the increase was from 
5.3 to 5.8. 

Lung cancer is now the leading cause of 

14 THE CANADIAN NURSE 



death from cancer in Canada for men and for 
men and women combined. Twenty-four 
percent of male cancer deaths and five percent 
of female cancer deaths were due to this disease 
in 1967. 

"The tragedy is that so many lung cancer 
deaths are preventable," Mr. Munro said. "Most 
are attributable to cigaret smoking. Obviously 
the best prevention is for a person to never start 
the habit. However, it usually takes many years 
of exposure to cigaret smoke before lung cancer 
develops. As long as the disease is not already 
present, on discontinuance of smoking the risk 
of its development gradually decreases until it 
approaches that of a non-smoker. The risk of 



other cigaret-smoking diseases - chronic bron- 
chitis, emphysema, and coronary heart disease 
- also decreases when the habit is dropped. 

"There is, unfortunately, a time lag between 
changes in smoking practices and mortality 
from related diseases." Mr. Munro added. 
"Favorable changes in the former are not 
immediately refiected in the statistics. 
However, the benefits of discontinuing smoking 
are already indicated by the experience of 
British doctors, a large number of whom have 
stopped. Between the periods 1954-57 and 
1962-64, the doctors' lung cancer death rate 
decreased 30 percent while that of British male 
population increased 25 percent. 



AMNIHOOK 

disposable amniotic membrane perforator 




economical 

time-saver 

provides 

protection for 

both mother 

and child 



AmniHook provides the doctor with an improved 
technique for inducing labor by amniotomy. The 
instrument's rounded, blunt end and protected 
sharp point are designed to safeguard mother and 
fetus against injury. AmniHook has benefits for 
the hospital too. Each AmniHook is individually 
sterile-packed and ready for use, so it may be 
stored right in the labor room. Once used, the 
AmniHook is discarded, saving both the time and 
expense of resterilization. 

L^ HOLLISTER 

HOLUSTER INC., 211 E. CHICAGO AVE., CHICAGO, ILL. 6061! 

lANUARY 1969 



We won't take just any nurse 

Only those committed narses willing to work 
for a low salary under demanding conditions in 
any of 45 developing countries around the world 




To pick up this professional challenge, 
you have to be highly motivated. Eager 
to put your own talent to work. Aware 
of the need of developing countries for 
mature, competent people, ready to 
lend a hand. You have to decide to 



spend two years of your life working 
on the world's number one problem — 
development. 

If we're getting to you, you aren't 
just any nurse. You're the kind of 
nurse we need at CUSO. 



Tell us what you can do. We'll tell you where you are needed. 

I would like to know more about CUSO (Canadian University Service Overseas) 
and the opportunity to work overseas for 2 years. My qualifications are as follows: 



I hold- 



(degree or diploma) 
Post graduate courses, if any. 



-in nursing, from. 



(university or school of nursing) 



My present type of work is- 

Other experience 

Name 



i#i.5^: 



Address- 



Send to: CUSO (Information) 
151 Slater Street, Ottawa, Ontario 



-Prov. 



CUSO 

Development 
Is our business 



JANUARY 1%9 



THE CANADIAN NURSE 15 



news 



MARN Co-sponsors Program 
For inactive Nurses 

Winnipeg. - If Manitoba is to attain the 
recommended minimum of 450 nurses per 
100,000 population by 1970, an annual in- 
crease of five percent must be maintained. To 
this end the Manitoba Association of Registered 
Nurses and the Manitoba Hospital Commission 
are co-sponsoring a refresher course for inactive 
nurses who have been previously registered. 

The shortage of nurses in Manitoba eased 
slightly during the fall after an acute shortage 
during the summer. There are still shortages in 
parts of the province, however. 

Although no new hospital beds were opened 
in Metropolitan Winnipeg during 1968, addi- 
tional facilities are presently being planned or 
are in construction, and they will require addi- 
tional nurses. MARN maintains the shortage is 
due to too many nurses being held in adminis- 
trative or clerical duties, while non-skilled 
personnel are caring for patients. The high 
mobility rate of Manitoba nurses increases the 
problem. 

BC Nurses Begin Two Workshops 

Vancouver. - Twenty-three nurses began 
the first in a series of Intravenous Therapy 
Courses at St. Paul's Hospital, Vancouver, on 
Sept. 9. The courses are sponsored by the 
hospital, the Registered Nurses' Association of 
British Columbia, and the B.C. Hospital Asso- 
ciation. The second in the series is to begin 
February 14. The entire group takes a week of 
theory and then groups of four nurses return 
for the clinical part of the course. Because of 
this, the second course will extend until June 
27. 

The first in a series of eight-week Intensive 
Care Nursing courses begins at Vancouver Gen- 
eral Hospital on January 6. This is sponsored by 
The Vancouver General Hospital, RNABC, and 
BCHA. The B.C. Hospital Insurance Service is 
underwriting the cost of the full-time instruc- 
tor, Shirley Stokes, who has worked for several 
years in the cKnical area of intensive care and 
emergency at The Vancouver General Hospital. 

Housing Affects Health 

Ottawa. - Health workers can influence 
planning for housing and help to ensure that it 
is based on social, cultural, and personal needs, 
according to a consultant with the Department 
of National Health and Welfare. 

Dr. H.N. Colburn presented a paper entitled 
"Health and Housing" to the Canadian Confer- 
ence on Housing, meeting in Toronto October 
20-23. Health workers have a special contribu- 
tion to make, according to Dr. Colburn, 
because of their knowledge of people as indi- 
viduals rather than masses. For the most part 
they are not making this contribution, he 
stated. 

Dr. Marvin Lipman, a consultant on urban 
environment with Central Mortgage and 

16 THE CANADIAN NURSE 



"Fasten Seat Belt, Please' 




Pontiac, Mich. ~ The American Seat Beh Council's new safety slogan, "Don't be a 
Buckle Boob," is penetrating even into hospital halls, as noted here. Barbara M. 
Gast of Royal Oak, Michigan, buckles up in her wheelchair at St. Joseph Mercy 
Hospital, Pontiac, Michigan, at the direction of nurse Jane Gallagher. Hospital 
installed, the belts protect weak or very ill patients who might otherwise tumble 
from chairs. American Safety Equipment Corporation helped solve the problem 
with a special adaptation of its airplane seat belts, standard on many airlines. 
Barbara, who had an accident with her car on her way to classes at Oakland 
University, now has a double appreciation of the value of seat belts. 



Housing Corporation, stresses an increasing 
need for a greater range of choices in housing 
environment for all Canadians, including low- 
income groups. More amenities to make the 
home not merely a shelter, and more opportu- 
nities in housing to allow for varied forms of 
management and ownership are also necessary. 
The Canadian Conference on Housing was 
sponsored by the Canadian Welfare Council, 
with the financial support of Central Mortgage 
and Housing Corporation, the Ontario provin- 
cial government, and industry. 



Father Should Dominate 
Says Hamilton Doctor 

Vancouver. - The dominant member of the 
family should be the father, even during preg- 



nancy and labor, according to Dr. Murray 
Enkin of Hamilton, Ontario. 

Dr. Enkin was speaking to a meeting spon- 
sored by the National Childbirth Trust in 
Vancouver October 3. He said that the domi- 
nant role during pregnancy and labor can be 
maintained by training the husband, who then 
trains his wife, in the psychoprophylactic 
method of childbirth. During labor, it is the 
husband who will give the commands, rather 
than a doctor. 

Dr. Enkin, who teaches the psychopro- 
phylactic method at St. Joseph's Hospital, 
Hamilton, illustrated his lecture with slides. 
Some 100 nurses, prenatal teachers, and obste- 
tricians attended the meeting. □ 

[be A BLOOD D0N0R| 

JANUARY 1969 



New Nursing Books 



Understand how and why drugs act 

The Pharmacologic Basis of Patient Care 

by Mary Koye Asperheim, B.S., M.S., R. Ph., University of Wisconsin 
Hospitals. 

This brand new text and reference uses a refreshing 
new approach to pharmacology. Instead of giving a 
list of diseases, drugs, and dosages to be memorized 
by rote, it explains the basic principles and concepts 
so that you understand how specific drugs work and 
why they ore used. Miss Asperheim gives excellent 
brief reviews of the chemistry and physiology involved 
in drug action, and offers a concise "refresher course" 
in the mathematics of drugs and solutions. She dis- 
cusses methods of administration; the absorption, fate, 
and excretion of drugs; allergic reactions and immu- 
nity. Then she takes up each class of drugs in turn, 
from topical antiinfectives to radioactive drugs. All 
important information on each drug is presented in 
one place. Chapters on diagnostic drugs, toxicology, 
and drug addiction and habituation complete the 
coverage. Each chapter opens with an outline of the 
important concepts to be discussed, and ends with 
questions for discussion and review. 

417 pages, illustrated. $7.60. New — Published October, 1968. 

Facts that concern every nurse 

The Nurse and the Law 

by Harvey Sarner, LL.B. 

In this fact-filled new book, an experienced attorney 
gives sound, constructive advice on problems that 
every practicing nurse must face daily. In a clear, 
direct style, he explains such complicated subjects as 
malpractice, negligence, liability, and privileged com- 
munications. He discusses contracts, wills, and work- 
men's compensation; tells how to get the best insurance 
coverage for your particular needs at the lowest cost; 
shows you how to make secure provision for your own 
retirement; and points out ways you can minimize 
your taxes. A wise counselor, Mr. Sarner advises you 
not only on how to meet legal problems, but on how 
to ovoid them — advice that no nurse can afford to 
be without. 

219 pages. $7.05. New — Published April, 1968. 



Appreciate nursing's heritage 

History of Nursing 

by Josephine Dolan, R.N., M.S., University of Connecticut. 

From the magic of the witch doctor to the miracles of 
modern surgery, this well-known text traces the influ- 
ences of religion, medicine, and the biological and 
social sciences and weaves them into a comprehensive 
picture of the emergence of nursing as a profession. 
In the New (12th) Edition, just published, Miss Dolan 
has completely revised and considerably expanded the 
text and added thirty new illustrations. You'll find the 
most recent developments in nursing practice descri- 
bed, including Project HOPE, the Peace Corps, and the 
important changes in the structure of the National 
League for Nursing that were effected in 1967. 



380 pages 
1968. 



with 310 illustrations. $9.20. New — Published August, 



Concise review of current clinical nursing 

Saunders Tests for Self-evaluation 
of Nursing Competence 

by Dee Ann Gillies, R.N., M.A., Cook County School of Nursing, 
and Irene Barrett Alyn, R.N., M.S.N., University of Illinois. 

This new self-teaching and self-evaluating review of 
clinical nursing is ideal for students and graduates 
who are preparing for examinations as well as for 
nurses changing to a new specialty or returning to 
practice after an absence. For each specialty area — 
Maternity and Gynecologic, Pediatric, Medical-Surgical, 
Psychiatric — the authors describe typical case histo- 
ries and presenting situations, then ask a series of 
perceptive questions about them. As the cose develops, 
more information is introduced and more questions 
asked. Each unit includes a helpful bibliography and 
there is a complete index. Perforated IBM-type answer 
sheets (and correct answers) ore provided. 

426 pages. $7.30. New — Published April, 1968. 




— ^ -■ - ' - .V ' i^JH 

W. B. SAUNDERS COMPANY Canada Ltd., 1835 Younge Street, Toronto 7 

Please send on approval and bill ma: 

n Asperheim: Pharmacologic Basis of Patient Care ($7.60) D Dolan: History of Nursing ($9.20) 

D Sarner: The Nurse and the Law ($7.05) D Gillies & Alyn: Self-evaluation ($7.30) 



Name: .. 
Address: 
aty: 



.Zone: Province: 



lANUARY 1%9 



CN I-69 
THE CANADIAN NURSE 17 



names 





Sally Tretiak Glenna M. Gorrill 

Sally Tretiak (B.A., U. Manitoba; R.N., 
Winnipeg General; M.A. (Admin.N.Ed.), 
Columbia U., New York) and Glenna M. Gorrill 
(R.N., Gait School of Nursing, Alta.; Dipl. 
Teach, and Superv., U. Alberta; B.Sc. N., Leth- 
bridge Junior College, U. Alberta; M.N., U. 
Washington)„have joined the teaching staff of 
Red Deer Junior College in Red Deer, Alberta. 

Miss Tretiak served with the World Health 
Organization as an educator in south-east Asia 
before becoming associate professor at the 
school of nursing, University of Alberta. Her 
earlier career inclu<Jed numerous positions as 
staff nurse, supervisor and instructor in Mani- 
toba, Ontario, and Nova Scotia. 

Miss Gorrill's career has been centered in 
Lethbridge, Alberta. She was head nurse at Gait 
Hospital; assistant associate director of nursing 
service at Lethbridge Municipal Hospital; and 
associate director of nursing education at Gait 
School of Nursing. 

^^M^^^ Mary Peever (R.N., 

^^^^H|H||l Royal Victoria H., 

^^^^^^^k Montreal; Cert.P.H.N., 

W.^ _ ^ P B.N., U. Man.; M.Sc, 

■T^V^'IKPH U. Colorado) was 

^ y^w^ ^r appointed chairman of 

•*' -9 W the department of 

^ '■■^^^Jf' nursing education at 

■Al ^^f Mount Royal Junior 

mt^t^i College, Calgary, in 

August 1968. Prior to this appointment. Miss 

Peever was instructor in maternal and child 

nursing at the College (see "Names" April 

1968). 

Appointed assistant professor in public 
health nursing at the University of Saskat- 
chewan is Jean Coppock (R.N., Alberta H., 
Ponoka; B.N., McGill; M.Sc, Boston U., Mass.). 

After working as a staff nurse and then head 
nurse at Alberta Hospital in Ponoka, Miss 
Coppock was appointed nursing supervisor at 
Lamed State Hospital, Kansas. After spending 
two successive years as staff nurse at Eloise 
State Hospital in Wayne, Michigan, and at St. 
Francis Hospital in Honolulu, Hawaii, she re- 
turned to Canada where she was appointed 
head nurse at Alberta Hospital in Edmonton. 

From 1964 to 1966, she was employed by 

18 THE CANADIAN NURSE 




the World Health Organization at the University 
of Ghana, Africa, as instructor in clinical 
psychiatric nursing. 



Three appointments have been announced 
to the faculty of the school of nursing at 
Oshawa General Hospital, Ontario. 

Marjorie Hicknell 
(Reg.N., St. Mary's H., 
Kitchener; Dipl. N. Ed., 
B.Sc.N., U. Western 
Ont.) has been named 
assistant director of 
nursing education. Miss 
^ ^^I^^^H Hicknell has worked in 
^ <^'»^a Sudbury, Edmonton, 

London, and Sarnia as a 
staff nurse. She spent eight years as a teacher in 
the school of nursing, Victoria Hospital in 
London, Ontario. 

Megan Russell (B.N., U. Manitoba) has been 
appointed as a teacher. Mrs. Russell previously 
taught at The Children's Hospital of Winnipeg. 

Audrey Wilson (Reg.N., Toronto General; 
B.Sc.N., U. Western Ont.) is named medical- 
nurgical teacher. Mrs. Wilson worked for 10 
years at the Montreal Neurological Institute as 
general staff nurse, head nurse, and instructor. 

Hazel Wilson 

(Reg.N., Ottawa Civic 
H.; Cert. Admin. & 
Superv., P.H.N., 
B.Sc.N., U. Toronto; 
Cert. P.H.N. , M.Sc.N., 
McGill) has recently 
been appointed to the 
Research and Planning 
Branch of the Ontario 
Department of Health. 

Miss Wilson worked as a public health nurse 
in Alberta, Manitoba, and Ontario. From 1951 
- 1959 she was supervisor of nursing in the 
Kenora and district health division. Prior to 
attending McGill, she was regional consultant 
with the public health nursing branch of the 
Ontario Department of Health. 

The board of directors of the American 
Nurses' Association has announced the resig- 
nation of Judith G. Whitaker, R.N., as 
executive director. Before assuming her post in 
1958, Mrs. Whitaker had served as deputy exe- 
cutive director for six years. 

The president of ANA, Dorothy A. 
Cornelius, paid tribute to Mrs. Whitaker, 
saying: "During her tenure as executive direc- 
tor, the Association has increased its member- 
ship, more than doubled its staff and operating 
budget, and effected a basic reorganization in 





order to extend its activities and functions on 
behalf of nursing in the public interest. Mrs. 
Whitaker has visited and worked with the con- 
stituent associations in all 50 states and has 
served on a variety of national and international 
commissions dealing with virtually every aspect 
of nursing." 

Mrs. Whitaker has agreed to continue to 
serve as executive director until September 
1969 to enable the Association to select a 
successor. The board of directors has expressed 
regret in accepting the resignation but hopes 
that Mrs. Whitaker will continue at least for a 
time to serve the Association in some other 
capacity. 



Margaret E.V. Irwin 

(Reg.N., Hamilton Civic 
H.; B.Sc.N., U. Western 
Ont.; B.L.S., U. 
Toronto) has returned 
to the Victoria Hospital 
School of Nursing as 
librarian. 

Before attending 
library school. Miss 
Irwin worked successively as staff nurse, in- 
structor, and librarian at the Victoria Hospital 
School of Nursing. 

Catherine Reban 

(B.Sc.N., U. Sask.) has 
been named instructor 
of nursing funda- 
mentals at Mount 
Royal Junior College in 
Calgary. Miss Reban 
worked for a number of 
years with the Saskat- 
chewan Department of 
Public Health in Rosetown and with the 
Alberta Department of Public Health in 
Calgary. She also taught maternal and child care 
for one year at University Hospital in 
Saskatoon. 



Several new staff members have been 
appointed to the faculty of the University of 
Toronto School of Nursing. Named assistant 
professors are: Norma Dick (B.A., B.Sc.N., U. 
British Columbia; M.Sc.(A), McGill), formerly 
supervisor of inservice education at The Van- 
couver General Hospital; Hilda Mertz (B. 
S.(N.Ed.), U. Pittsburgh, Pennsylvania; M.S.N., 
Yale U., Connecticut), formerly director of 
clinical nursing in McLean Hospital, Massachu- 
setts; and Beverly Mitchell (B.Sc.N., U. British 
Columbia; M. P.H., Michigan U.), who, prior to 
her appointment, was director of nursing servi- 
ces. Mental Health Services, Vancouver. 

lANUARY 1%9 




ICN President Receives Order of Canada 




Alice Girard, president of the International Council of Nurses, was among 27 
outstanding Canadians who were invested in November with the Medal of Service of 
the Order of Canada. The investiture ceremony took place at Rideau Hall, Ottawa 
and was presided over by Governor-General Roland Michener. 
After the ceremony, a private dinner was held at Government House. Dr. 
Mussallem, executive director of the Canadian Nurses 'Association, attended as Miss 
Girard's guest 



Named lecturers are: Michelle Brideau 
(B.ScN., U. Ottawa; M.Sc.N., U. Western On- 
tario); Diana Gendion (B.Sc.N., Florida State 
U.; M.N.Ed., U. Syracuse, New York); Margaret 
Wyness (B.Sc.N., U. British Columbia); Vivian 
Ewart. Jane Harlock, Elizabeth Jack, Eva 
Kandorovskis, Mary McCulley, Judith MacKay, 
Ruth Winkler, all graduates of the University of 
Toronto School of Nursing. 

The newly appointed lecturers will assist in 
cUnical teaching. 

Ottilia M. Bieber (R.N., 
Regina Grey Nuns' H.; 
Dipl. P.H.N., U. Saskat- 
chewan; B.N., McGill) 
has been appointed 
public health nursing 
education consultant 
with the public health 
nursing division of the 

Saskatchewan health 

deparment. 

Miss Bieber will take part in the expansion 
and coordination of field experience in public 
health nursing for students from the university 
and the diploma schools of nursing in Saskat- 
chewan. 

Before joining the provincial health depart- 
ment in 1957, Miss Bieber held positions in 
doctors' offices, general hospitals, and was an 
epidemiology worker with the venereal disease 
control division of the British Columbia health 
and welfare department. 

Since joining the Saskatchewan department, 
she has provided public health nursing service as 
a staff nurse and was assistant to the regional 
JANUARY 1%9 





nursing supervisor in the Weyburn-Estevan 
health region. She was promoted to regional 
nursing supervisor of the Yorkton-Melville 
health region in 1960 and transferred to a 
similar position in the Regina rural health 
region in 1963. 



Nicole Du Mouchel 

(R.N., Ste.-Justine H., 
Montreal; B.Sc.N. 
(Admin.), Institut Mar- 
guerite d'Youville, 
Montreal; M.Sc.N., U. 
Montreal) has been 
awarded the Warner- 
Chilcott scholarship, 

which will enable her to 

study nursing abroad. Upon her return, she will 
report in detail on her trip. 

This is the second year that the pharma- 
ceutical firm Warner-Chilcott has offered a 
scholarship to students graduating from the 
faculty of nursing. University of Montreal. Last 
year, Mariette Desjardins and Sister Lorraine 
Beaudin toured the Scandinavian countries on a 
Warner-Chilcott scholarship. The report of this 
trip is about to be published. 

This year, three students at the master's 
level qualified for the scholarship: Sister Rachel 
Rousseau, Lisette Arcand, and Nicole Du 
Mouchel. As the judges could not come to a 
decision, lots were drawn. The name of the 
winner was announced at the annual meeting of 
the Association of Nurses of the Province of 
Quebec held in Montreal, October 31 to 
November 1, 1968. 



Next Month 



in 



The 

Canadian 
Nurse 



• hyperbaric oxygen units 

• two-year nursing programs 



nursing service organizations, 
— a modem approach 






Photo credits for 
January 1969 



Toronto General Hospital, p.36 

Dominion-Wide, Ottawa, p.8,39,43 

EUefsenLtd., p.l2 

Jack Marshall & Co. Ltd., 
Cooksville, p.40 

Graetz Bros. Ltd., Montreal, p.41 

JuUen Lebourdais, Toronto, p.42 

Tara Dier, Ottawa, p.43 



THE CANADIAN NURSE 19 



nm flUMiiv PRODucis 




POSEY SIT-'N SAFETY BELT 

(Potent Pending) 

Holds patient upright on commode, stroight- 
bock, or wheelchoir; prevents slumping for 
word. Secures potient to commode with 
sofety privacy ond without nurse s constant 
supervision. Shoulder strops may be used in 
the front, straight over the shoulders or 
criss-crossed. Adjusts to fit virtuolly oil po- 
tients. Cot. No. 4220. $14.85 eoch. 




POSEY VELCRO WHEEL CHAIR 
SAFETY STRAP 

Keeps patient from falling out of his wheel 
choir. Fits virtually any size patient. Self- 
adhering surfoce provides easy, quick ad- 
justment. Eosily ottoched; strop remains ot- 
toched to choir when not being used; for 
added safety, if desired, choir moy be equip- 
ped with one strop across waist and one 
across lop. Mode of 2-inch wide Velcro 
covered, webbing. No. 4188 (2-piece), $6.30 
each. 



WRIST OR ANKLE RESTRAINT 

A friendly restraint available in infant, small, 
medium ond large sizes. Also widely used for 
holding extremity during intravenous injection 
No. P-450, $6.00 per pair, $12.00 per set. With 
DECUBITUS padding, No. P.450A, $7.00 per 
pair, $14.00 per set. 



POSEY PRODUCTS 
Stocked in Canada 

ENNS & GILMORE LIMITED 

1033 Rangeview Road 
Port Credit, Ontario, Canada 





August 1968 - June 1969 

The National League for Nursing is 
sponsoring o series of 12 two-day 
workshops in several U.S. cities for 
persons involved in administration, 
planning, and evaluation of hospital 
nursing services. The first workshop 
was held in San Francisco August 9, 
1968, and the last will be held in 
Miami Beach, June 26-27, 1969. 

The workshops ore designed for 
nurses and others interested in nurs- 
ing audits, new staffing patterns, and 
hospital staff development programs. 

Further information and applica- 
tion forms for registration may be 
obtained from the Department of Hos- 
pital Nursing, National League for 
Nursing, 10 Columbus Circle, New 
York, New York 10019. 

January 20-23, 1%9 
February 10-13, 1%9 
March 20-23 1969 
April 14-17, 1%9 

Regional conferences on the use of 
audiovisual aids in nursing, sponsored 
by the Registered Nurses' Association 
of Ontario. To be held in London in 
January, Sudbury in February, Ot- 
tawa in March, and Fort William in 
April. Fee: RNAO members, $25; non- 
members, $35. Write to: RNAO, 33 
Price St., Toronto 5. 

February 17-19, 1969 

Second Canadian Conference on Hos- 
pital-Medical Staff Relations, Chateau 
Frontenac, Quebec City. Theme: Better 
communications for better patient 
care. Sponsored by Canadian Hospital 
Association, Canadian Medical Asso- 
ciation, and Canadian Nurses' Asso- 
ciation. 

February 24-27, 1%9 

Association of Operating Room Nurses, 
16th annual meeting, Cincinnati, Ohio. 

March 24-29, 1%9 

Symposium on recovery room and in- 
tensive care nursing, Grace General 
Hospital, Winnipeg. Registration: $20. 
For further details: Miss J.W. Robert- 
son Director - Inservice Education, 
Gra'ce General Hospital, 300 Booth 
Dr., Winnipeg 12. 

April 13-17, 1969 

American Association of Neurosurgi- 
cal Nurses Meeting, Cleveland, Ohio. 
Information may be obtained from: 



Miss S.M. Sawchyn, 99 Fidler Ave., 
St. James 12, Manitoba. 

May 19-23, 1%9 

National League for Nursing, 1969 
convention. To be held in Cobo Hall, 
Detroit, Michigan. Fee: NLN members, 
$15; non-members, $25. Write to: 
NLN, 10 Columbus Circle, New York, 
N.Y. 10019. 

May 21-23, 1%9 

Registered Nurses' Association of Brit- 
ish Columbia, annual meeting. Bay- 
shore Inn, Vancouver. Write: RNABC, 
2130 W. 12th Ave., Vancouver 9. 



May 21-23, 1969 

Canadian Hospital Association, 2nd 
national convention. Civic Centre, Ot- 
tawa. 

June 1-13, 1969 

Eighth annual residential summer 
course on alcohol and problems of ad- 
diction, Trent University, Peterbor- 
ough, Ont. Co-sponsored by I rent 
University and the Addiction Research 
Foundation, an agency of the province 
of Ontario. 

June 16-18, 1969 

Conference on nursing education for 
visitors to the International Council of 
Nurses Quadrennial Congress. Spon- 
sored by the school of nursing and 
alumni association. University of To- 
ronto. June 19-20: tours in Toronto 
and environs to be arranged at re- 
quest of persons attending conference. 
Apply to the Secretary of the School, 
University of Toronto School of Nurs- 
ing, 50 St. George St., Toronto 5. 



June 22-28, 1969 



COUNCIlDiPIUKtS 




COM It II laTfRWiioaAi 
DESINFIOMIf*!! 

iivtcoacxt 

au*DMI(MM IMI 



20 THE CANADIAN NURSE 



International Coun- 
cil of Nurses' Qua- 
drennial Congress, 
Montreal. Fee: be- 
fore Jan. 22, $40; 
after Jan. 22, $60. 
Write to: ICN Con- 
gress Registration, 
50 The Driveway, 
Ottawa 4, Ont. 



August 8-10, 1969 

Reunion of Moncton Hospital School of 
Nursing Alumnae, New Brunswick. 
Members of all classes, 1909-1969, 
welcome. Write to: Alumnae Reunion 
Committee, c/o The Moncton Hospital, 
Moncton, N.B. ^ 

JANUARY 1969 



Teach your students 

nutrition as a vital part of 

total patient care! 



A New Book! 



Williams 



NUTRITION AND 
DIET THERAPY 

Your students in "Nutrition and Diet Therapy" courses can gain a lucid 
understanding of nutrition's vital role in nursing care with the aid of this 
precisely written new text. Correlating basic nutrition with patient-cen- 
tered nursing, this superbly illustrated new book presents its subject in a 
manner which clearly reflects today's total patient care concept. Through- 
out this new text, basics of nutrition are interpreted specifically for ap- 
plication as dynamics in nursing care through an appropriately drawn 
balance of normal and applied nutrition. It helps the student to clearly 
see the correlation of food chemistry, human body chemistry, and physi- 
ological and emotional needs with the overall aspects of effective care. 

CUnical application of all scientific principles aids the patient-centered 
focus. Separate units emphasize the role of nutrition in public health; 
nutrition in the basic nursing specialties (obstetrics, pediatrics, psychi- 
atry, and rehabilitation); and nutrition in the clinical management of 
medical and surgical disease. Each aspect is considered in the context of 
human need. Diagrams, illustrations, study questions, outlines and 
glossaries illuminate basic concepts . . . and thought-provoking dis- 
cussion questions introduce each chapter. A student workbook provides 
a knowledge of biochemical concepts and their clinical applications 
through a problem-solving approach. A helpful teacher's manual offers 
valuable advice on planning and conducting your course in nutrition. 

By SUE RODWELL WILLIAMS, M.R.Ed., M.P.R., Instructor in Nutrition and Cli- 
nical Dietetics, Kaiser Foundation School of Nursing; Nutritional Consultant and 
Program Coordinator, Health Education Research Center, Permanente Medical 
Group, Oakland, Calif. Publication date: February, 1969. Approx. 672 pages, 7"x 
10", 117 illustrations, including original drawings by George Straus. About $9.75. 




Fij. 12-8. Research in food chemistry. A chemist in 
the U.S. Department of Agriculture's Agricultural 
Research Service makes an adjustment on a mole- 
cular still used in a project to aid in the manufac- 
ture of dry milk. (USDA photograph.) 





A completely up-to-dat 
comprehensive, and 
authoritative new text thl 
Includes such outstandingf 
features as: 

• An excellent correlation of basic 
trition with nursing care; 
Easy-toHinderstand information in tfw 
basic substances essential to body 
chemical function and their general 

specific purposes in health and 
se; 

An excellent presentation of the 
broad community aspects of nutri- 
tion, prevention and control; 

# Discussions of nutrition and its role 
in conception, growth and develop- 
ment, and childhood nutrition defici- 
ency disease states; 

Discussions of nutrition in medical- 
surgical nursing that explore specific 
areas in detail, providing a manual 
of diet therapy with emphasis on 
metabolic aspects. 



THE C.V. MOSBY COMPANY, LTD 

86 Northline Road • Toronto 16, Ontario 



'lANUARY 1%9 




Publishers 



THE CANADIAN NURSE 21 



new products { 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




New Covers for Stryker Frames 

Sets of a newly designed cover for the 
Stryker Turning Frame are now available. These 
new covers were designed by nursing staff and 
have the following advantages: more comfor- 
table for the patient as they remain smooth and 
tight on the frame; easy to apply; the one size is 
easily adjusted to fit different sized frames. 

For further information and prices, write to 
G.A. Hardie & Co. Ltd., 1093 Queen St., W., 
Toronto 3. 






Disposable Bulb Syringe 

This sterile, disposable bulb syringe for use 
in hospitals has finger grips and printed calibra- 
tions. The unit, called Medaseptic D, has a full- 
draw vinyl bulb with the same suction power as 
a standard reusable bulb. 

Medaseptic D has a catheter tip with a tip 
protector. Materials used to produce both the 
bulb and syringe are inert and will not affect 
the fluids they touch. Shatterproof polypropy- 
lene is used in the production of the unit's 
barrel. 

Further information is available from Baxter 
Laboratories of Canada, Limited, 6405 
Northam Drive, Malton. Ont. 
22 THE CANADIAN NURSE 



Publication Available 

A recently published booklet entitled 
Highlights of a Study on Single- Unit Drug Dis- 
pensing gives highlights of an Owens-Illinois 
survey on single-unit drug dispensing in 
hospitals, which was completed in early 1968. 

Single-unit drug distribution is a system of 
packaging drugs in individual doses ready to 
administer to the patient. 

Among advantages of dispensing of drugs in 
unit doses are: possible reduction of medication 
errors; more efficient administration of medi- 
cations and utilization of hospital personnel; 
better inventory control; and better cost 
accounting. 

Findings of the study have prompted 
Owens-Illinois to develop a unit-dose packaging 
system. 

Marketed under the trade name Uni-Pak, the 
system consists of amber vials in two sizes, 
aluminum convenience closures, cappers, and 
hinged plastic boxes for packaging medications. 

Further information may be obtained from 
Owens-Illinois, Toledo, Ohio 43601. 



Climestrone Tablets 

Climestrone Tablets are the water-soluble 
conjugated form of estrogens, extracted from 
natural sources (equine) and standardized with 
the addition of sodium estrone sulfate. 

These tablets arc indicated in the treatment 
of menopausal symptoms; postmenopausal 
osteoporosis; to supplement declining estrogen 
levels in the postmenopausal female; functional 
uterine bleeding; postpartum breast engorge- 
ment and other conditions associated with in- 
sufficient endogenous estrogen. 

Cyclic therapy (a 3-week regimen followed 
by a 7-day rest period) is recommended to 
avoid continuous stimulation of breast and 
uterus. 

Full information is available from Charles E. 
Frosst & Co., P.O. Box 247, Montreal 3. 



, P.O. Box 247, Montreal 3. 





jyn-Aid 

Gyn-Aid is a new medical device for keeping 
a patient's legs spread apart during an ex- 
amination in which the lithotomy position is 
required, such as pelvic, rectal, or urological ex- 
amination, or minor surgery. 

Designed by a gynecologist, Gyn-Aid saves 
the physician's time and allows the patient to 
relax. Slight pressure inward by the thighs holds 
the Gyn-Aid in place without strain. 

Gyn-Aid is manufactured of strong plastic, 
which is unbreakable with normal use. As it is 
applied over the drape sheet, frequent cleaning 
is not required. 

Further information may be obtained from 
Custom Products Company, 2614 N. Seaman 
Ave., El Monte, California 91733. 



* * » 




Plastazote 

Plastazote, a new thermoplastic splinting 
material, is made of foamed, very light poly- 
ethylene. It is molded directly on the patient's 
body. Plastazote is nontoxic, unaffected by 
acids and alkalies, and can be kept clean by 
washing with hot water and detergents. 

Plastazote, used with or without rein- 
forcement by lamination, is supplied in perfo- 
rated sheets in one-quarter to one-inch thick- 
nesses. It is prepared in a thermostatic oven at 
140°C. for a minimum of five minutes. It is 
then applied to the patient and molded to his 
exact shape. After about 20 seconds, as it cools, 
it begins to set. 

In addition to limb and body supports, Plas- 
tozote has extensive application in the ortho- 
pedic footwear field, providing insoles that give 
immediate relief to the patient. 

For further information write to the 
Medical Division, Smith & Nephew Ltd., 2100 - 
52nd Ave., Lachine, Que. 

JANUARY 1969 



new products 




Miniset 

This new vein infusion set, called Miniset. i> 
useful for infusing either intravenous solutions 
of blood to restless patients, infants, or patients 
with fragile, rolling veins. 

The new set features a slim, one-piece design 
which permits the needle to be held close and 
flat against the skin. Soft and flexible securit\ 
wings on the needle permit a firm grip for con- 
trolled needle placement. When taped flat 
against the skin, these security wings assure 
conformation to skin contours. 

Miniset also contains a short, thin-wall, 
stainless needle, which provides greater fluid 
flow, even with smaller gauges. 

The Miniset's flexible tube, security wings, 
and short needle reduce the possibility of 
pressure necrosis or phlebitis. 

Further information is available from Baxter 
Laboratories of Canada, Limited, 6405 
Northam Dr., Malton. Ont. 




Nourishment Station With 
Microwave Oven 

This microwave and nourishment station is 
a self-contained work station which provides all 
faciUties for service of regular meals, between 
meal nourishment, and special diets. 

Patients trays can be prepared in the central 
kitchen and wheeled directly into the micro- 
lANUARY 1%9 



wave and nourishment station's holding refri- 
gerator. Food to be heated is removed from the 
holding refrigerator and placed in the micro- 
wave oven unit. The patient is served directly 
from the microwave oven, which insures that 
the food is hot and attractive. 

The station also includes two hot plates 
(one with thermal eye), an automatic coffee 
maker with 60-cup-per-houi capacity, and an 
ice dispensing unit which makes, stores, and 
dispenses sanitary ice directly into the patient's 
container. 

Other faciUties include: dry storage area 
with adjustable shelves, utility drawer; tilt-out 
removable waste receptacle; counter space; 
large stainless steel sink with soap dispenser and 
hot and cold water faucets; paper towel dispen- 
ser: counterlevel and overhead fluorescent 
lights, and two three-prong electrical outlets. 

Write to the Market Forge Co, 35 Garvey 
St., Everett, Mass. for a descriptive brochure. 




Transport Seat 

This transport seat is ideal for carrying a 
patient short distances in crowded areas. The 
seat may remain under the patient during air- 
plane trips or while he is in the wheelchair. 
Straps over the attendant's shoulders help 
distribute the patient's weight. The straps may 
be removed when not in use. The transport seat 
is excellent for moving invalids on and off air- 
planes or other vehicles. 

Address inquiries to: Posey Products 
stocked in Canada, B.C. Hollingshead Ltd., 64 
Gerrard St. E., Toronto 2. 

Actified-A 

Actifed-A is indicated for the relief of con- 
gestion, aches, pain, and fever associated with 
colds and sinusitis. It is an orally effective 
potentiated combination of "Sudafed" (de- 
congestant), ActidU (high potency antihista- 
mine) and acetaminophen (effective analgesic 
and antipyretic). 

For further information: Burroughs 
Wellcome & Company (Canada) Limited, 60 
Riverview Ave., LaSalle, P.Q. 




Largest-selling among nurses ! Superb lifetime quality . 

smooth rounded edges . . . featherweight, lies flat . . . 

deeply engraved, and lacquered. Snow-white plastic will 

not yellow. Satisfaction guaranteed. GROUP DISCOUNTS. 
SAVE: Order 2 Identical Pins as pre 
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♦ IMPORTANT Please add 25c per order handling charge on all orders of 
3 pins or less GROUP DISCOUNTS 25 99 pins. 5'., 100 or more. 10%. 



Remove and refasten cap»»,0., Tp,aa 
band inslanlly for launder- I 'Of)* iSCs 
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molded black plastic tac, „ ' P Cap C 
dainty gold cadeucem. No. U ^^^ ^ 

6TacsPerSet 200 U ooiy 

SPECIALI 12 Sets (60 Tacs) »9. total 





CROSS Pen and Pencil 

World famous Cross wnlmg instruments wilh 
Sculptu'ed Caduceus Emblem Lilelime guarantee 

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I No. 6603 $8.00 No. 3503 $5.00 
No. 6602 8.00 No. 3502 5.00 
No. 6601 16.00 No. 3501 10.00 



Personalized ^/NDAGE 
SHEARS 

6" professional, precision shears, forged 
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No. 1372B Shears (no initials) 
SPECIAL! 1 Doz. Shears 
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add 50c per pair. 



ZIPPO Lighter 



with Caduceus 
Emblem 



Famous Zippo, chrome finish, engraved gfeen and 
-"- Caduceus Lifetime "Fix-it-free" Guararitee 



yello' 

No. 1610 Lighter 



6.00 ea. ppd. 



*^^T3„u.«-. Waterproof NURSES WATCH 

Swriss made, raised silver full numerals, lumin. mark- 
ings. Red-tipped sweep second hand, chrome stainless 
case. Stainless expansion band plus FREE black leather 
strap. 1 yr. guarantee. 
No. 06-925 12^ la. ppd. 



Sterling Silver "Click-Apart" KEY RING 



Keep car key on small rmg, detach 
instantlir for parking lot, servicing, etc. 

No. 8968C (Caduceus) or 8968 (plain) 
(Add $1. for up to 3 engraved initials) 



75ea. OT , 



PRINCESS GARDNER NURSES BILLFOLD 

Fine imported pigskin, reptile band, bill 
divider, com pocket. lemovable photo-card 
case, key slots, etc. With gold stamped 

•^x Caduceus or plain Specify Brown, Red oi Blue. 

Jy No. 30R55C (Caduceus) or 30H55 (plain) 
itamped Initials add $1.) 5.00 ea. ppd. 



TO: REEVES COMPANY, IHIebofo. Mau. 02703 U.S.i. 



I ORDER NO. ITEM QUANT. PRICE I 




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THE CANADIAN NURSE 23 



in a capsule 



A heart of rubber 

Hearts of rubber may some day be added to 
the crooner's tunes about hearts of gold and 
hearts of stone. The Goodyear Tire & Rubber 
Company is busy developing an artificial heart 
made of natural rubber and polyurethane. It 
has kept sheep and calves alive as long as 50 
hours. The researchers hope that by 1970 the 
rubber heart can be used to keep people alive 
until a human heart becomes available for 
transplant. 

The tire company is working in cooperation 
with medical research teams at the Cleveland 
(Ohio) Clinic and the University of Utah. 
Goodyear spokesmen say that rubber resembles 
human tissue more closely than any other 
substance. It expands and contracts much like 
natural tissue and will do so in rhythm with the 
artery to which it is joined. 

The rubber heart can pump two gallons of 
blood a minute. It is powered by an external 
source of air power but, in future, may be 
powered by portable nuclear reactors. 

Jim Wright, Goodyear's man with many 
hearts, to date has built more than 30 rubber 
hearts. 



The enigmatic sex 

Men - cheapskates and spendthrifts, fickle 
and faithful, aggressive and timid, possessive 
and protective, Casanovas, perfectionists, 
narcissists, egoists, playboys, and bores. 

They're all in L'homme cet animal retif, 
which literally translated means "man - this 
restive animal." "Retif," however, is an elusive 
word; its meaning lies somewhere among obs- 
tinate, unmanageable, unpredictable, and 
incomprehensible. In short, it says the same 
thing about men that men have been saying 
about women for centuries - they're impos- 
sible to pin down and impossible to understand. 

L'homme cet animal retif, is co-authored by 
Colette Gagnon, a federal government trans- 
lator, and Agathe Legault, assistant editor of 
L'infirmiere canadienne. It's the product of 
consultations with clairvoyants, schoolmarms, 
graven images, lovers, beautiful people, hypo- 
crites, hearts of stone, separatists, executives, 
Romeos, rigolos, gigolos, robots, aristocrats, 
mama's boys, career women, Ophelias, guardian 
angels - and others. 

If you're the last bit serious about brushing 
up your French, reading this book may be the 




24 THE CANADIAN NURSE 



most enjoyable method you've discovered in a 
long time. A person who speaks French fluently 
would spend one or two hours chuckling over 
the foibles of men bared in this book. If your 
French is anything less than fluent, you'll spend 
longer, but the diverting cartoons and casual 
style will beguile you into spending the time to 
decipher Mile Legault's and Mile Gagnon 's 
witty and penetrating remarks about that lova- 
ble yet infuriating sex. 

It's published by Lidec Inc., 1083 Van 
Home Avenue, Montreal 154, and sells in 
Canada for two dollars. 

A very special place 

"For business or pleasure, stay at Toronto's 
***, a very special place. It's like a few days in 
Rome ... or Paris ... or even swinging London 
town. The *** can turn a business trip into a 
relaxing time. Dine, dance, or stay awhile at 
Toronto's ***, a very special place." 

So goes the ad, murmured over the air in 
liquid, seductive tones. It seems that certain 
Ontario nurses succumb to the insidious pre- 
sence of the media, because they recently 
staged a four-day conference at the hotel in 
question. 

It's too bad, though, that they didn't check 
the price list. Or if those who planned the 
conference did, it's regrettable that the rank 
and file nurse who attended the conference 
wasn't given a sneak preview of incurrable 
expenses. 

If Nurse Patricia likes an abstemious. Con- 
tinental breakfast of juice, rolls and coffee, she 
must be prepared to be relieved of $1.75. If 
she's used to hearty English breakfasts of juice, 
cereal, bacon and eggs, toast and coffee, she'll 
have to dig into her pocket to the tune of 
$3.25. Not to mention tips. 

Did you know that substantial breakfast of 
fresh orange juice, ham and eggs, toast and 
coffee can be had at Oscar's, New York's 
Waldorf Astoria's breakfast nook, for two 
dollars? But then that's expensive American 
money. 

A lot of nurses lost a number of pounds 
during that conference. They went on the 
cheap at breakfast, skipped lunch, and dined on 
$3.25 omelets for dinner (no coffee). They 
would have sneaked elsewhere for meals if their 
sleeping accommodation hadn't been an island 
paradise with taxi service only, to the finer 
spots in the heart of the city. 

No wonder nurses are agitating for higher 
.salaries. 

Fix Bozo sick leg 

Were you upset when you noticed Bozo's 
missing foot in the December mini-editorial? 
The presses rolled to a dead stop when our 
efficient liaison with the printer noticed this 
glaring "error" in the artwork! 

JANUARY 1969 




Who Prefers 

explosion-proof suction units? 
"We do," say most 0. R. nurses. 

Here's why : 

Gomco Explosion-Proof Suction Pumps are 
ready for life-protecting service because of 
their dependable, quiet operating pump, pre- 
cision regulating valve and gauge, explo- 
sion-proof, heavy-duty motor and 
sealed-in switch. Cabinet, portable, 
and stand-mounted units. 

Are your operating rooms prop- 
erly equipped with Gomco? For 
latest catalog, see your dealer 
or write: GOMCO SURGICAL 
MANUFACTURING CORP., 828 
E. Ferry St., Buffalo. N.Y. 14211 



No. 929 explosion-proof 
major suction unit. 







Countdown to Congress 



During 1968 the message in nursing journals all over the world has been 
"Come to Canada for ICN Congress 1%9." Here's what nurses in other countries 
have been reading about us. 



Loral Graham 




If they can make it, you can make it 



In the past year, Canada, Canadians, 
and Canadian nurses have received im- 
pressive coverage in the nursing journals 
of the world. Nurses all over the world 
know that Canadian nurses will be 
hostesses for the largest Congress in the 
history of the International Council of 
Nurses. They have been told that Canada 
is a country as wide as the distance be- 
tween Stockholm and Bombay; that it is 
a country with a distinct international 

Mrs. Graham is Assistant Editor of T H E 

CANADIAN NURSE, 



26 THE CANADIAN NURSE 



flavor, and that Canadians move easily and 
readily in international circles. And 
they've been assured of one thing more: a 
cheerful, warm, welcome from the Can- 
adian Nurses' Association and its 80,000 
members. 

The Irish Nurses' Journal, a pocket- 
sized magazine, devoted seven-and-one- 
half pages of the 20 pages of its August 
issue to ICN and the 1969 Congress. The 
editorial, although not specifically about 
ICN, was entitled "Focus on the Future," 
the theme of the Congress. An article by 
Martha G. Shout, Nurse Adviser to the 
JANUARY 1969 



ICN, outlined the history of ICN and its 
contribution to the 20th century. A full- 
page "Nursing in Canada Statistical 
Survey" told Irish nurses how many 
nurses there are in Canada, where they 
work, and where they were educated. 

Australian nurses have been saving 
their money since August 1967 when they 
were first informed in The Australian 
Nurses' Journal that they could combine 
six- to eight-week world tours with their 
visit to Montreal in June 1969. Their tours 
will include visits to intriguing places like 
Bangkok, Acapulco, Papeete, Nandi, 
Beirut - and Vancouver. Belgian nurses, 
too, have been offered package-deal 
tours, but their tours will be centered in 
North America. Canadian points of 
interest on their itinerary include Ottawa, 
Toronto, and Niagara Falls; the remainder 
of their time will be spent in the United 
States seeing nature's wonders in the 
Grand Canyon, trying to resist the slot 
machines in Las Vegas, breathing smog in 
Los Angeles, and craning their necks in 
New York City. 

Other national nursing magazines have 
corresponded with the Canadian Govern- 
ment Travel Bureau and the National 
Film Board to give their nurses a glimpse 
of some of the more spectacular or color- 
ful aspects of Canada's geography and 
history. Danish nurses have paused to 
look at the postcard favorite, Maligne 
Lake in Jasper National Park; a rare 
closeup of curly-horned mountain sheep 
also in Jasper National Park; and one of 
the classic photographs taken in the 
Yukon Territory in the 1890's showing a 
string of prospectors in overalls, braces, 
JANUARY 1969 



and floppy wide-brimmed hats mucking 
for gold in a long, wooden sluice. 

In their national nursing magazine, 
French nurses have had an apportunity to 
view a photo of "un spectacle qui vous 
coupe le souffle" - the Maid of the Mist, 
Niagara Falls. They may also know a little 
more than most Canadians do about 
Jeanne Mance, thanks to a photo of her 
statue in Quebec City and an article by a 
doctor from Langres, France about her 
life of service to the sick in 1 7th century 
French Canada. 

The Netherlands Jaarboekje 1968 dis- 
played an imaginative, colorful cover on 
which a map of the Netherlands, a 
symbol of the Dutch nursing organ- 
ization, and a globe representing the 
International Council of Nurses, were 
linked by rays of the sun. The Philippine 
Journal of Nursing printed an article 
about the Congress in a section entitled 
"Around the World in Nursing," illus- 
trated with sketches of a nurse reading a 
newspaper, and a globe. The Nigerian 
Nurse entitled a reprint of the program of 
the Congress "Countdown to Montreal." 

Since March 1968, the monthly 
Nursing Journal of India has printed five 
articles about Canada and nursing in Can- 
ada. The Jamaican Nurse, a colorful 
journal with a black and orange cover, 
devoted three pages of its April-May issue 
to Canada and the Congress. German 
nurses, in Deutsche Schwestern Zeitung 
have had an opportunity to read a history 
of nursing in Canada from its beginnings 
in Quebec City, as well as articles on 
nursing education in Canada by CNA's 
consultants in nursing education, Marga- 



ret Stees and Shirley Good. 

The award for the most engaging copy 
concerning the ICN Congress must, how- 
ever, go to the Japanese Journal of 
Nursing Kango. According to the typed 
insert stapled ontu the inside front cover, 
an "Invitation of the Applicants to the 
14th ICN Convention" can be found on 
page 101. Sure enough, on page 101 is a 
neat half-page boxed item complete with 
title in bold type. Otherwise, to my 
uninitiated eye, it is a decorative display 
of Japanese characters. Scrutinizing it a 
little more closely, however, I found the 
significant arable letters 14, 1969. and ICN 
buried among the artful symbols. 

The Hellenic Nurse ran an equally in- 
timidating page of script on the 1969 
Congress but had the mercy to head it 
with a bilingual (French and English) 
symbol of ICN '69. The Journal of 
Nursing published by the Nurses' Asso- 
ciation of the Republic of China was even 
more benevolent to Western and, in 
particular, English-speaking readers. This 
magazine printed an entire page in 
English the complete program of the 
Congress. One can scarcely quibble over 
typographical slipups such as "poas- 
besic" for "postbasic". The mind boggles 
over the problems of setting even one line 
in Chinese in the magazine you are now 
reading! 

All smiles aside, the message that 
nursing journals all over the world have 
been relaying to their readers is 
capsulized" in the nurses' journal of 
Colombia: "Bienvenida al Canada." If 
they can make it you can make it - see 
you there! D 

THE CANADIAN NURSE 27 



The value of 
revascularization surgery 

Revascularization procedures offer an excellent chance of a good result in 
98 percent of patients with coronary artery insufficiency. 



Arthur Vineberg, M.D. 



Throughout the past 23 years of 
experimental and clinical attempts to 
increase the oxygenated blood supply to 
ischemic myocardium, surgeons have 
been guided by the following generally 
accepted facts: 

1. Coronary atherosclerosis involves the 
coronary arteries in their epicardial 
courses. 

2. The disease is diffuse and progressive, 
gradually involving main stem and surface 
branches of the coronary vessels. 

3. The arterioles lying within the 
myocardia of the right and left ventricles 
are disease-free except in severe diabetic 
and hypertensive patients. There are three 
main arteriolar zones, namely, those 
supplied by the right, anterior 
descending, and circumflex coronary 
arteries respectively. 

4. The heart muscle contains large, 
lake-like vascular spaces (myocardial 
sinusoids) lying between muscle bundles 
into which extra coronary oxygenated 
blood can be introduced without 
formation of hematoma. 

Based on these facts, all our 
revascularization efforts have aimed at 
introducing new sources of oxygenated 
blood deep in the left ventricular 
myocardium and, more recently, into the 
right ventricular myocardium. It has been 
our aim to revascularize the entire heart 
through the coronary arteriolar networks, 

Dr. Vineberg is a former associate professor of 
surgery at McGill University, Montreal, and is 
now senior cardiac surgeon at The Royal 
Victoria Hospital, Montreal. 



28 THE CANADIAN NURSE 



which are normally supplied by the 
diseased coronary arteries. This has been 
accomplished by introducing multiple 
sources of extra cardiac blood and by 
uniting separate arteriolar zones so that 
all arterial blood entering the heart 
muscle is distributed throughout the 
entire heart. 

To this end, the left internal mammary 
was implanted into the left ventricular 
wall in 1945 in the experimental animal. 
During the succeeding five years, we 
learned that an internal mammary artery 
implanted into the left ventricle of a 
normal dog's heart would remain patent 
for years, providing it was implanted deep 
in the interior wall. It started to bud in 12 
days and formed true, arterial branches 
that joined surrounding intramyocardial 
arterioles between the third and sixth 
week. When the anterior descending and 
circumflex coronary arteries were 
narrowed at their origins in the 
experimental animal by ameroid 
constrictors, the implanted internal 
mammary artery formed anastomoses 
with the arterioles of the entire left 
ventricle at the end of six months or 
longer; there were never communications 
with the right coronary system. 

Tri-arteriolar zones 

There are three areas in the left 
ventricle where the terminal branches of 
all three coronary arteries end. I have 
termed these tri-arteriolar zones. 
Theoretically, an implanted internal 
mammary artery placed into one of the 
tri-arteriolar zones is capable of 
JANUARY 1969 



REVASCULARIZATION OF ENTIRE HEART BY RIGHT AND LEFT 
VENTRICULAR IMPLANTS, EPICARDIECTOMY WITH BLOODLESS 
OMENTAL GRAFT VINEBERG. 



RIGHT IMPLANT 
INTO RIGHT 
VENTRICLE 




LEFT IMPLANT 
INTO LEFT 
VENTRICLE 



EPICARDECTOMY 



FREE OMENTAL 
GRAFT 



!f?- 



THESE OPERATIVE PROCEDURES CONVERT HEART 
INTO ONE LARGE ARTERIOLAR NETWORK AND ARE 
EFFECTIVE REGARDLESS OF THE TYPE OF CORONARY 
CIRCULATION OR LOCATION OF ISCHEMIA. 



revascularizing the entire heart. The first 
of these is on the interior surface of the 
left ventricle near the apex. It is here that 
whenever possible single implants have 
been placed in human hearts. 

The second tri-arteriolar zone lies 
more laterally near the junction of the 
diaphragmatic and lateral surface of the 
left ventricle. This zone has been 

I implanted accidentally in the past and 
deliberately since October 1967. Arteries 
lying in both of the above-mentioned 
zones have been examined by injection 
studies from 3-1/2 to 17-1/2 years after 
implantation and have frequently been 

' JANUARY 1%9 



shown to fill all three coronary arteries 
retrograde to points of coronary 
occlusion. 

The third tri-arteriolar zone lies high 
up on the posterior wall of the left 
ventricle in its inner one-third, making 
access to this zone technically difficult. 

1 believe it is better to leave the 
patient's own arteries alone and to 
provide multiple, large and small 
by-passes that do not block throughout 
the years. 

If placed in the inner half of the left 
ventricular wall, internal mammary 
arteries implanted into the myocardium 



will remain open even though there is no 
myocardial ischemia. This is because the 
artery is surrounded by arterioles with 
diastolic pressures of 40 mm. Hg, as 
compared with the diastolic pressure of 
80 mm. Hg within the implanted internal 
mammary artery itself. It has always been 
our objective to connect with the 
arterioles in the myocardium, not, as has 
been suggested by some, with the surface 
vessels. 

To remain open, a superficially 
implanted vessel requires a markedly 
diseased superficial vessel so that there 
will be a pressure differential between the 
two vessels. Operations that attempt to 
connect with the surface vessels are not in 
accordance with the principle of 
myocardial revascularization that we have 
enunciated and followed since 1950. The 
coronary vessels in their epicardial 
courses become diseased. In time, 
implanted internal mammary arteries 
primarily communicating with such 
vessels will be more likely to block off 
than if they were deeply implanted, 
connecting with intra-myocardial 
arterioles, such as has been experienced 
with grafts in peripheral vascular surgery. 

Implant in man 

In 1950, the first internal mammary 
artery implant was performed on a man, 
placing the artery in the anterior wall of 
the left ventricle. Since that time, many 
hundreds of patients have undergone the 
single internal mammary artery 
implantation for relief of myocardial 
ischemia due to coronary artery 
insufficiency, with less than two percent 
operative mortality and an overall 80 
percent improvement. Clinical experience 
clearly indicated that the internal 
mammary artery, after implantation, 
took at least nine months to function. 
For this reason, patients with angina 
decubitus did badly when the internal 
mammary artery alone was implanted. 

Accordingly, in 1956 I stopped doing 
single internal mammary artery 
implantation operations in patients with 
angina decubitus or chronic left 
ventricular failure and did not operate on 
such patients until December 1962, when 
the supplementary procedure of free 
THE CANADIAN NURSE 29 



omental graft had been fully tested in the 
laboratory. 

There have been many critics of the 
internal mammary artery implant 
procedure. At first it was called a 
string-like artery that always blocked. 
This, of course, is not true. 1 have 
patients who have been operated on and 
studied up to 17-1/2 years after internal 
mammary artery implantation. Many of 
these patients have died from other 
causes, such as fights, cancer, pneumonia, 
and meningitis. 

A total of 42 patients were examined 
at autopsy and injection of the internal 
mammary artery with Schlesinger mass, 
which does not penetrate anything 
smaller than an arteriole, filled the entire 
coronary circulation. Thirty-eight of the 
42 patients (88 percent) studied many 
years after surgery had fully patent 
internal mammary arteries with extensive 
mammary coronary anastomoses. Four of 
these patients were examined 3-1/2, 4, 
12-1/2 and 17-1/2 years after internal 
mammary arterial implantation. All their 
coronary arteries were blocked at their 
origins and the internal mammary artery 
was the only artery in the heart. 
Twenty-two patients underwent coronary 
arteriographic studies of the internal 
mammary artery for 6 months to 12-1/2 
years after surgery. Seventeen of these (77 
percent) showed good 
mammary-coronary anastomoses. Of the 
64 patients studied, either by pathology 
or by cine angiography, 54 patients (84 
percent) had fully patent internal 
mammary arteries that formed 
mammary-coronary anastomoses with the 
surrounding arterioles. 

Free omental graft 

It became clear that the internal 
mammary artery only supplied the 
arteriolar zone into which it was 
implanted. For this reason, 
epicardiectomy was added to open 
collaterals between the anterior 
descending and the circumflex areas. 
Epicardiectomy of the left ventricle, 
however, does not open collaterals 
between the right and left coronary 
arteriolar systems. This has been 
accomplished by the free or bloodless 
omental graft. 

After many years of experimentation, 
it was found that the free omental graft 
penetrates the wall of the aorta, the 
pericardium, and the epicardium covering 
the coronary arteries to obtain arterial 
blood for itself. When the bloodless 
omental graft is thus interposed between 
the pericardium and heart, it obtains 
oxygenated blood on both its surfaces by 
forming arteriolar communications 
30 THE CANADIAN NURSE 



between its own vessels and the 
pericardial vessels and those of the aorta 
and diaphragm. This oxygenated blood 
flows from high to low pressures and thus 
from extra cardiac sources into omental 
vessels and thence into the coronary 
systems. 

Removal of the epicardium assists the 
graft to form its communications with 
the heart, arteries, and arterioles. Such a 
graft distributes oxygenated blood from 
right to left or left to right coronary 
systems, as well as adding another extra 
source of oxygenated blood to the 
ischemic myocardium. When combined 
with implantation of left internal 
mammary artery into left ventricular 
wall, patients with angina decubitus can 
be safely operated on with good results. 
Likewise, patients with chronic left 
ventricular failure have had their chronic 
left ventricular failure reversed. Over 200 
patients have undergone the combined 
operation of left internal mammary 
artery implantation, epicardiectomy, and 
free omental graft. For those patients 
who have no angina at rest, the operative 
mortality has been under 4 percent, with 
an overall 90 percent improvement. 

The free omental graft as a 
revascularization procedure has a long, 
documented, experimental background. 
In addition, it has been used clinically for 
nearly six years. We now have clinical 
evidence of its viability in both living 
patients and in patients who have died 
from strokes and other causes, up to four 
and three-quarter years. Not only has 
there been viable omentum, but the 
vessels within the omentum have been 
shown, through Schlesinger mass 
injections, to be in full communication 
with the coronary arterial system and the 
arterial network in the mediastinum. 

When the free omental graft fails to 
live, it is because proper epicardiectomy 
and sero-pericardiectomy have not been 
carried out, nor has the omental graft 
been fixed by multiple sutures to the 
heart and to the aorta. Like the original 
internal mammary artery, this valuable 
operative procedure is under criticism and 
will continue to be so until it is used 
properly. 

With the addition of the right internal 
mammary artery implanted into the right 
ventricular wall, there has been no 
operative mortality and no late mortality 
up to two and one-half years. This 
includes seven patients who had angina 
decubitus at the time of surgery. 



Type of patient 

It should be made clear in reporting 
results, what type of patient is operated 



upon. In our own series, 75 percent of 
the patients have had from 1 to 6 
myocardial infarctions 25 percent have 
had left ventricular failure, and 27 
percent have had left ventricular 
hypertrophy. There has been reversal of 
left ventricular failure in 65 percent of 
the patients operated upon who suffered 
chronic left ventricular failure at the time 
of operation, and 80 to 90 percent of the 
patients have no pain, slight pain, or less 
pain. 

It is also important to know the 
condition of the left ventricle with regard 
to function, size, and distribution of scar. 
In the many series of cases reported by 
others, it is quite clear that the majority 
of patients have had minimal or no 
myocardial infarctions at the time of 
surgery and few, if any, have chronic left 
ventricular failure. This is obvious as it is 
impossible to place two internal 
mammary arteries into the left ventricular 
wall when there is a good sized scar in 
either the anterior or posterior walls or in 
both walls of the left ventricle. 

It is likewise important to know where 
the points of occlusion are located in the 
coronary arteries, particularly if they are 
in the main stems or wherever they are 
more distal. Results will vary greatly 
when the occlusion in the coronary artery 
is 3 to 4 cm. away from the origin and 
not at the origin. 

Evaluation 

Evaluation of postoperative results 
must include the evaluation of the clinical 
condition of the patient. It cannot be 
entirely cine angiographic evidence of the 
relief of a localized perfusion deficit. The 
relief of anginal pain, the correction of 
chronic ventricular failure, and the ability 
of the patient to return to his or her 
former occupation are also important. 

In evaluation of the results of surgery, 
cine angiographic evidence of patent 
internal mammary artery or arteries 
showing that extra cardiac blood is 
reaching the heart muscle is of great 
value, but it does not supply the proof 
that the patient has been relieved of his 
symptoms. Surgeons like myself, who, in 
addition to implanting one or two 
arteries, are supplementing the procedure 
with epicardium and free omental graft 
find it impossible to outline by cine 
coronary arteriography the multitudinous 
small arterioles that deliver blood to the 
ischemic heart via the free omental graft. 

Limitations 

With usage, certain limitations have 
become apparent. 

Limitations of Left, Internal Mammary 

JANUARY 1%9 



Artery Implantation into Left Ventricular 
Wall 

1. Damaged left internal mammary artery 
from other chest injuries. Rare. 

2. Previous ligations of internal mammary 
arteries at the second inter-space. Rare. 

3. Damage due to extensive pleuritis. 
Extremely rare. 

4. Atherosclerosis of left subclavian 
artery at point of origin of internal 
mammary artery. Rare. 

5. Hypertrophy of left ventricle. An 
implanted artery, even though it remains 
open, is too small to supply a large 
muscle mass alone. Two implants plus 
epicardiectomy and free omental graft are 
ideal. 

6. Diffusely streaky, scarred left 
ventricle. Implanted internal mammary 
arteries in such ventricles have no run-off 
and few arterioles for its branches to 
anastomose with. 

7. Thin-walled, left ventricles, caused by 
myocardial ischemia, are difficult to 
implant. Some have been implanted 
successfully. 

■Limitations of Epicardiectomy 

1. Obliterative pericarditis from 
myocardial infarction or previous 
operation. Rare. 

2. Extensive sub-epicardial fat deposits. 

3. Diffuse intermittent scar. 

'Limitation of Free Omental Graft 
Applied to Omental Surface 

The greater omentum itself may be 
absent (gastrectomy) or scarred 
(peritonitis) or damaged from previous 
operations. In the latter situation, the 
lesser omentum is used. 

Limitations of Multiple Internal 
'Mammary Artery Implantations 

1. Thin, fat, or scarred anterior wall of 
the right ventricle, making right internal 
mammary artery implantation into right 
ventricular wall hazardous or impossible. 
Rare. 

2. Extensively scarred anterior or 
posterior walls of the left ventricle permit 
left internal mammary artery 
implantation only. Usually, there is not 
enough good muscle in such ventricles to 
accept more than one artery. 

limitations of Gastro-Epiploic 
Artery Implantation 

Unlike the internal mammary artery, 
the gastro-epiploic artery is frequently 
itherosclerotic. In addition, it cannot be 
mplanted into the left ventricular 
Dosterior wall if this is scarred or is not 
ong enough to go laterally. 
ANUARY 1%9 



Limitations of Segmental Resection, 
Patch-Graft or A rterialization 
By Vein Graft 

A small percentage of patients have 
segmental disease. In the majority of 
cases, the disease is diffuse. 

The principle of treating localized 
obstruction in the surface arteries is 
wrong, if long duration of relief from 
myocardial ischemia is expected. As 
coronary artery disease progresses, 
obstructions may occur distal to the 
point of the localized area of arterotomy. 
These will lead to a reduction of flow and 
eventual occlusion in the segmentally 
treated area. 

Recently, surgeons at one of the 
clinics that had performed a large series 
of segmental patch-grafts indicated that 
they were no longer doing this type of 
operation because 29 percent of their 
patch-grafts had blocked and 13 percent 
had become narrowed. In other words, 42 
percent were not functioning 
satisfactorily. These surgeons have 
suggested, instead, a vein replacement 
graft. There is no evidence to suggest that 
the arterioles in the myocardium become 
diseased, nor is there any evidence that 
the internal mammary artery implanted 
within the arteriolar network develops 
atherosclerosis. 

The various operations that we have 
developed and have listed along with 
some others, with their limitations, is our 
reason for constantly searching for 
additional techniques of myocardial 
revascularization to supplement the 
internal mammary artery implant 
procedure. However, the combined 
operations of left internal mammary 
artery into left ventricular wall alone, or 
in combination with right internal 
mammary artery into right ventricular 
wall, epicardiectomy and free omental 
graft, can be used for total cardiac 
revascularization in practically all 
patients, as one can see from the 
foregoing list of limitations. There are 
many centers claiming to perform our 
operations, but they are not following 
techniques that I have proven to be of 
value. 

Intramyocardial Omental Strip Implant 

This operation is our most recent 
addition to our revascularization 
procedures. In this procedure the great 
omentum, after its removal from the 
colon, is laid upon a piece of plate glass 
and three strips of omentum containing 
one or two blood vessels are cut out 
one-half inch wide in such a way that the 
upper end of the strip communicates with 
a wide and fan-shaped piece of omentum 
containing numerous vessels. The 



fan-shaped piece of omentum is wrapped 
around the ascending aorta and the 
narrow tails are threaded through the left 
and right ventricular walls, both 
anterioriy and posterioriy. This operation 
has proven to be of value in maintaining 
the life of an animal with triple ameroid 
coronary artery occlusion. 

The intramyocardial portion of the 
omental strip forms arteriolar 
communications with the arterioles of the 
myocardium within eight days, and the 
portion around the aorta does likewise by 
tapping the aortic wall so that the aortic 
blood flows into the ventricular 
myocardium within eight days. 

Since an implanted omental strip graft, 
unlike an implanted internal mammary 
artery, requires no run-off, but actively 
attaches itself to any arteriole in its 
vicinity, taps the aorta, and conveys 
oxygenated blood from high to low 
pressure areas in the myocardium, this 
operation is planned for the treatment of 
large, intermittently scarred left ventricles 
in failure, in combination with resection 
of large anterior and/or posterior scars. 
The omental strip implant is still 
experimental and will not be applied by 
us in the treatment of the large heart in 
heart failure until it has been more 
thoroughly tested in the laboratory. It is 
in the third year of experimental testing. 
It may be the answer to the 
intermittently diffusely scarred large 
heart. 

We have not developed new 
revascularization procedures because of 
dissatisfaction with our original internal 
mammary artery implant, but rather to 
support this procedure and for use when 
the heart pathology makes a systemic 
artery implant unlikely to succeed. As 
long as 30 percent or more of the left 
ventricular muscle mass remains, 
revascularization has a chance to work. 
Many patients with large hearts upon 
which 1 have operated are still alive; 
others have lived from two to four and 
three-quarter years after surgery, many 
with marked improvement. 

Until such time as the rejection 
phenomenon has been solved, a 
combination of revascularization 
procedures with or without local excision 
of large left ventricular scars must be 
given serious consideration for all large 
hearts before heart transplantation is 
considered. Revascularization procedures, 
either direct or indirect, offer an 
excellent chance of a good result in 98 
percent of patients with coronary artery 
insufficiency. □ 



THE CANADIAN NURSE 31 



Advances in surgery 
for coronary artery disease 

A summary of some of the major developments in cardiovascular surgery 
and a glimpse at possible advances in the future. 



A.S. Trimble, M.D., B.Sc. (Med.), F.R.C.S. (C), F.A.C.S. 



Arteriosclerotic coronary artery dis- 
ease is the commonest cause of car- 
diac disability and death in Canada 
and the United States. Although the 
surgical management of the chronic 
form of this condition has now become 
commonplace, this was not so eight 
years ago. Indications, methods of in- 
vestigation, and surgical techniques 
have changed during that period. This 
review will summarize some of the 
major advances in the field and briefly 
describe the latest developments in 
treating the acute form of heart attack. 

History 

The pioneering research of 
O'Shaughnessy' and Vineberg-' laid 
the experimental foundation for revas- 
cularization of the myocardium. Dr. 
Vineberg's animal and clinical work 
proved that a bleeding internal mam- 
mary artery drawn into a tunnel in the 
left ventricular myocardium would de- 
velop collateral flow to th.; heart's own 
coronary arteries. This flow supplied 
by the implanted mammary vessel was 
adequate to prevent death in animals 
when the coronary artery was ligated 
and, in humans, led to relief of angina 
pectoris. 

Despite this remarkable work there 
was little enthusiasm for the technique 
and only limited clinical application. 
There were two major reasons for this. 
The vagaries of the symptom, angina, 
were well recognized and often place- 
bos or minor surgical techniques, such 
as sympathectomy, led to improvement 
32 THE CANADIAN NURSE 



in some cases. Also, the demonstration 
of a patent artery had not been done 
in the living, but shown by injection at 
autopsy. 

Early in the 1960s, two major de- 
velopments led to a complete change in 
the attitude of the medical profession. 
At the Cleveland Clinic, Sones* devel- 
oped the technique of selective coro- 
nary cineangiography. This involved 
the passage of a catheter up the bra- 
chial or femoral artery and its inser- 
tion into the coronary artery. Dye was 
then injected and high speed radio- 
graphs taken to outline the lumen of 
the vessel. Organic occlusions and ste- 
noses in each coronary artery could 
thus be documented accurately and 
related to symptomatology. Later, these 
same techniques were utilized to show 
patency and collateral flow from the 
injected internal mammary artery. This 
flow could be correlated to symptomatic 
improvement in the living, and thus a 
scientific means of evaluating the proce- 
dure was at hand. Sophisticated engi- 
neering developments of cineangiography, 
such as videotape and instant replay, have 
since been applied. 

The other major contribution was 
the long-term follow-up of some 30 
patients by Bigelow at al."'"'^ These 
doctors utilized the Sones' method to 
correlate symptomatic improvement 



Dr. Trimble is on the staff of the Car- 
diovascular Unit and Division of Cardio- 
vascular Surgery, Toronto General Hospital. 



and internal mammary patency in pa- 
tients as long as 13 years after opera- 
tion. Their presentation finally led to 
wide general clinical application of the 
internal mammary or Vineberg revas- 
cularization operation. 

Indications and contraindications 

Angina on effort, or with emotion, 
which interferes with the patient's abil- 
ity to work or enjoy life, has been the 
prime indication for operation. Usually 
a trial of medical therapy is under- 
taken first. Results to date suggest thai 
less disabled patients will be offeree 
the benefits of the operation in future 
Long-term follow-up will eventuallj 
justify the decision to make this a forrr 
of prophylactic surgery in the asymp- 
tomatic individual who has had a hear 
attack. 

Patients over the age of 60 anc 
young patients, who usually have i 
severe family history of the disease 
are considered less suitable. Gros; 
obesity, a recent coronary occlusion 
and congestive failure are contraindi 
cations. 

Investigations 

The routine history, physical exami 
nation, chest x-ray and electrocardio 
gram are followed by two special tests 
An exercise test, walking on a tread 
mill, documents the appearance of an 
gina after a certain distance. At thi: 
time an electrocardiogram is taken am 
compared to one taken while the pa 
tient was at rest. Changes indicatin; 



cardiac ischemia are often shown, sug- 
gestive evidence that the pain is related 
to organic disease. Then a selective 
coronary cineangiogram, previously 
described, is carried out. 

This catheterization study docu- 
ments the extent of the disease in the 
major coronary arteries and their 
branches. In addition, dye is injected 
into the left ventricular cavity to assess 
the efficiency of left ventricular con- 
traction. This has proven to be a most 
important criterion for acceptance for 
operation. 

Patients demonstrating a moderate 
to marked reduction in systolic con- 
traction, that is, the scarring has been 
so diffuse in the myocardium that little 
normal muscle remains, are usually 
denied the procedure. The risk is high 
and the chances for symptomatic im- 
provement slight. The catheterization 
procedure, although entailing a small 
risk, is thus essential for proper pa- 
tient evaluation. 

Two basic operative procedures are 
now available in chronic/arterioscler- 
otic coronary artery disease: revascular- 
ization and direct coronary artery 
surgery. 

Revascularization procedure 

At the Toronto General Hospital, 
the technique most commonly used is 
similar to that originally described by 
Vineberg.'- * ■'' The fifth interspace is en- 
tered through a left anterolateral thora- 
cotomy. The fifth costal cartilage is 
divided prior to insertion of the rib 
spreader to prevent traction on the in- 
ternal mammary artery and subsequent 
spasm. The artery is then carefully dis- 
sected, dividing the intercostal 
branches between silver clips, and in- 
cluding in the pedicle the accompany- 
ing vein and some periadvential tissue. 
At the level of the sixth interspace it 
bisects and at this level is divided. The 
dissection is then carried proximally to 
the second interspace. It is then wrap- 
ped in paparavine-soaked gauze to 
prevent spasm. 

A window is created in the fibrous 
pericardium exposing the anterolateral 
surface of the left ventricle. A tunnel 
JANUARY 1%9 



is made in the middle third of the 
myocardium, usually parallel to the 
left anterior descending coronary artery 
over a distance of 3 to 4 cm. Two or 
three clips are cut from side branches 
at the appropriate level in the internal 
mammary artery and, actively bleeding, 
it is drawn into the tunnel. The distal 
end is then secured with a suture. 

Prior to the resection of fibrous peri- 
cardium, the pericardial fat pad is dis- 
sected off, retaining its superior ped- 
icle. It is applied to the abraided epi- 
cardial surface of the left ventricle. 
The adhesions produced allow extra 
blood to enter through the pedicle and 
perhaps induce a more even distribu- 
tion of blood to the ventricle. 

Finally, a low stellate, high dorsal, 
left sympathectomy is done to prevent 
coronary artery spasm and possible 
myocardial infarction in the early post- 
operative period. The occurrence of 
this complication entails the major 
operative risk. 
Variations 

(a) Site of the Tunnel: There is, as 
yet, no proof that improved results are 
obtained if the artery is implanted in 
the area of ischemia — posterior or 
anterior. Some surgeons, however, pre- 
fer to create the tunnel in a site that 
prior electrocardiograph recordings 
and direct visual evidence suggest to 
be the worst area. 

(b) Bilateral Implants: Using a ster- 
num-splitting approach, both internal 
mammary arteries are dissected out as 
previously described.** The right is then 
inserted into a tunnel in the anterior 
wall of the left ventricle and the left 
mammary into the posterior wall. This 
operation entails a somewhat greater 
mortality and morbidity as compared 
to a single implant, but may be found 
to offer superior results once long-term 
follow-ups become available. 
Results 

Single internal mammary artery im- 
plantation entails an operative risk of 
two to three percent in properly select- 
ed cases.'"'-' The bilateral procedure has 
a slightly higher mortality. Follow-up 
studies show that 70 to 90 percent of 
patients are improved. This means that 



there is a major relief of angina — 
sometimes total — a reduction in med- 
ication, and resumption of a more nor- 
mal existence. 

Although not statistically proven, 
there is suggestive evidence that al- 
though the operation will not prevent a 
subsequent coronary thrombosis and 
myocardial infarct, it will make such 
an event less morbid and improve the 
chances of the patient surviving. It is 
for this reason alone that some centers 
may accept asymptomatic, post-infarct 
patients for operation. In most in- 
stances patient improvement can be 
correlated to a patent internal mam- 
mary implant, which, at cineangiogra- 
phy, demonstrates good collateral flow 
to the patient's own coronary arteries. 



Direct coronary artery surgery 

The majority of the patients cath- 
eterized at the Toronto General Hos- 
pital demonstrate tri-coronary artery 
disease — either occlusion or stenosis 
— of a varying degree. Some centers 
investigate less disabled patients and 
in some a localized block in the prox- 
imal portion of a single coronary ar- 
tery is demonstrated. These centers 
have operated on a number of patients 
using coronary endarterectomy or by- 
pass grafting. 

(a) Coronary Endarterectomy: To 
date, the left coronary artery has not 
proven amenable to direct procedures 
for anatomical reasons. A growing ex- 
perience is developing with such opera- 
tions on the proximal right coronary 
artery. Endarterectomy, usually with 
vein-patch angioplasty, was originally 
attempted because of its known suc- 
cess in carotid and femoral arteries. It 
involves an enucleation of the athero- 
matous plaques over the area of sten- 
osis or occlusion. The results published 
to date suggest an operative mortality 
of 20 to 25 percent, with 60 percent 
late improvement. Late occlusions 
demonstrated by cineangiography ap- 
peared common, however, and as a re- 
sult the following procedure is being 
evaluated. 

(b) Bypass Grafting: Saphenous vein 

THE CANADIAN NURSE 33 



bypass grafts from the ascending aorta 
to the coronary artery distal to the oc- 
clusion are now being evaluated. As 
described above, these procedures have 
proven valuable in peripheral vascular 
surgery. Initial results suggest a lower 
mortality than endarterectomy and im- 
proved late results in coronary artery 
disease. 



Acute coronary artery disease 

Acute coronary occlusion leading to 
myocardial infarction — a heart at- 
tack — often leads to sudden death. 
A large number of patients, however, 
do live long enough to enter hospital 
and there die, either from ventricular 
arrhythmias or congestive failure. In 
this group, advance has been made in 
both curative and supportive tech- 
niques. 
Curative 

Over 15 years ago, Murray sugges- 
ted that immediate resection of the 
dead muscle resulting from an acute 
coronary occlusion might lead to a 
higher survival rate.'" Subsequently, 
Heimbecker documented in animal ex- 
periments that this procedure, infarc- 
tectomy, could lead to a high survival 
rate." Human experience remains lim- 
ited to date. The indications in patients 
appear to be irreversible arrhythmias 
or congestive failure. 
Supportive 

(a) Non-Surgical: The development 
of coronary units,'- based on principles 
evolved in acute therapy units, has im- 
proved the survival rate from acute 
myocardial infarction. The advances 
include continuous electrocardiograph- 
ic monitoring, respiratory support, and 
new drugs. 

(b) Mechanical: A diverse number 
of mechanical supportive techniques 
have been devised and tested in animal 
experimentation. To date there has 
been limited clinical application. The 
various methods include artificial 
hearts, ventricular compression de- 
vices, counter pulsation, and partial 
bypass to mention a few. All have at- 
tributes and feasibility at least in the 
experimental laboratory. Many prob- 
lems, however, arise from their use — 
including thrombosis, red cell and pro- 
tein destruction, power source. 

A great deal of research is now 
making inroads into these problems. 
The development of an effective arti- 
ficial heart — either for total or par- 
ital support — or a heart-lung ma- 
chine capable of functioning for long 
periods would appear to be necessary 
for any of these devices to prove func- 
tional. 

Disabling coronary artery disease 

Two conditions should be defined: 
34 THE CANADIAN NURSE 



ventricular aneurysm and the "end 
stage" cardiac, who cannot be improv- 
ed by a revascularization procedure. 
Ventricular aneurysm 

This is an uncommon late complica- 
tion of myocardial infarction, which 
can lead to disabling angina or conges- 
tive failure. The scarred area of in- 
farcted myocardium balloons out to 
form an aneurysm — usually filled 
with clot that impairs myocardial func- 
tion. 

Utilizing cardiopulmonary bypass, 
the aneurysm can be excised. In a 
group of selected cases reported by 
Key et al'-' from the Toronto General 
Hospital, the operative mortality was 
about 10 percent with marked im- 
provement at follow-up. This might be 
described as infarctectomy in the 
chronic form of coronary artery dis- 
ease. 
End Stage Myocardial Scarring 

Most of the 74 heart transplant re- 
cipients so far reported suffered from 
disabling coronary atherosclerosis. 
These patients had reached the end 
stage of their disease and no treatment 
— medical or surgical — could im- 
prove their condition. The major prob- 
lems include donor supply and rejec- 
tion. Although transplantation remains 
a highly experimental procedure, its 
judicious, well-studied, continued ap- 
plication in the treatment of these pa- 
tients with no other hope for any life 
at all appears justified. 



The future 

This short review points out the two 
major areas in which future research 
will be concentrated. In the manage- 
ment of acute coronary thrombosis, 
with its high mortality, a wider appli- 
cation of the infarctectomy operation 
should occur. The perfection of mech- 
anical devices, both as supportive tech- 
niques and as artificial heart replace- 
ments, will be the real advance in the 
next 25 years. 

In the severely disabling form, heart 
transplantation will continue. If the 
basic scientists can ultimately identify 
and prevent the rejection phenomenon, 
and if the donor supply can be im- 
proved, it might become a routine 
procedure. Our experience to date with 
prosthetic valve replacement leads us 
to speculate that a truly mechanical 
heart will ultimately be developed. 
Whatever the case, the advances of the 
next 25 years in cardiac surgery will be 
as exciting as those of the past 15 
years. 

References 

I. O'Shaughnessy, L. An experimental 
method of providing collateral circula- 
tion to the heart. Brit. J. Surg. 23:665. 



1956. 

2. Vineberg, A.M. Development of an an- 
astomosis between the coronary vessels 
and a transplanted internal mammary 
artery. Canad. Med. Ass. J. 55:117, 
1946. 

3. Vineberg, A.M. Treatment of coronary 
artery insufficiency by implantation of 
the internal mammary artery into the 
left ventricular myocardium. J. Thorac. 
Surg. 23:42, 1952. 

4. Sones, F.M. Jr. and Shirey, E.K. Cine 
coronary arteriography. Mod. Cone. 
Cardiov. Dis. 31:735, 1962. 

5. Bigelow, W.G., Basian H., and Trusler, 
G.A. Internal mammary artery implan- 
tation for coronary heart disease. J. 
Thome. Cardiovasc. Surg. 45:67, 1963. 

6. Bigelow. W.G., Aldridge, H.E., Mac- 
Gregor, D.C. Internal mammary im- 
plantation (Vineberg operation) for cor- 
onary heart disease: cineangiography 
and long term follow-up. Ann. Surg. 
164:457, 1966. 

7. Aldridge, H.E., MacGregor, D.C, Lans- 
down, E.L., and Bigelow, W.G. Internal 
mammary artery implantation for the 
relief of angina pectoris — a follow-up 
study of 77 patients for up to 13 years. 
Canad. Med. Ass. J. 98:194, 1968. 

8. Favaloro, R.G. Double internal mam- 
mary artery implants — operative tech- 
nique. J. Tliorae. Cardiovase. Surg. 55: 
457, 1968. 

9. Favaloro, R.G., Effler, D.B., Groves, 
L.K., Sones, F.M. Jr., and Ferguson, D. 
G. Myocardial revascularization by in- 
ternal mammary artery implant proced- 
ures: clinical experience. J. Thome. Car- 
diovase. Surg. 54:359, 1967. 

10. Murray, G. The pathophysiology of the 
cause of death from coronary throm- 
bosis. Ann. Surg. 126:523, 1947. 

11. Heimbecker, R.O., Chen, C, Hamilton, 
N., and Murray, D.W.G. Surgery for 
massive myocardial infarction — an ex- 
perimental study of emergency infarc- 
tectomy. Surgery, 61:51, 1967. 

12. Brown, K.W.G., MacMillan, R.L., For- 
bath, N., Meligrana, F., and Scott, J.W. 
Coronary unit — an intensive-care cen- 
ter for acute myocardial infarction. Lan- 
cet, Aug. 17, p.349, 1963. 

13. Key, J. A., Aldridge. H.E., and MacGreg- 
or, D.C. The selection of patients for 
resection of left ventrical aneurysm. 
J. Tliorae. Cardiovase. Surg. (In print). 

D 



lANUARY 1969 



Nursing the patient 
after heart surgery 

Rapid developments in cardiac surgery in the last 15 years have meant exciting 
changes in nursing. Today, words such as mechanical respirators, cardiac monitors, 
central venous pressure, tidal volumes, defibrillators and blood gases, are as 
common to the surgical nurse as the word "heparin" was to her counterpart 
18 years ago. 



ludith R. Wass 

Each patient facing heart surgery 
approaches the event with fear, hope for 
the future, and expectations of the sur- 
geon, the nurse, and the hospital. Often it 
is difficult for him to discuss his post- 
operative care, as he is afraid to acknow- 
ledge the risks that he knows are involved 
in heart surgery. 

Naturally, previous surgery and 
hospital admissions influence the pa- 
tient's attitude to the operation he faces. 
Even so, each patient goes to surgery with 
the knowledge that his heart is his link to 
life. 

In the days preceding surgery, the pa- 
tient meets a variety of people - physio- 
therapists, x-ray technicians, blood tech- 
nicians, clerks. Somehow the nurse must 
interpret the roles of these health workers 
to the patient, and, at the same time, 
provide an atmosphere that allows him to 
express his fears, hopes, and expectations. 

ICU nurse visits 

Preoperative teaching is geared to the 
patient's understanding and acceptance of 
the operation. Usually the questions he 
asks indicate what further information he 
requires. Generally, however, he needs ex- 
planations about intravenous therapy, 
monitoring, chest drainage, oxygen 
therapy, deep breathing, and coughing. 

Prior to surgery, the patient receives a 

Miss Wass, a graduate of Toronto General Hos- 
pital School of Nursing, is Department Super- 
visor of the Cardiovascular Surgical Service at 
T.G.H. This year she is attending McGill to 
complete her bachelor of nursing degree. 



JANUARY 1%9 



visit from the nurse who will look after 
him postoperatively in the intensive care 
unit. This visit benefits both patient and 
nurse. The patient feels more secure in 
knowing the nurse who will be so im- 
portant to him postoperatively, and the 
nurse is able to evaluate the patient's 
physical state before she receives him in 
her unit. Also, the visit allows her to 
identify her patient as a person - some- 
thing that her preoccupation with tech- 
nical skills in the ICU unit might other- 
wise inhibit. 

The patient's family is not neglected 
during this preoperative period. Family 
members are told of the time of the pa- 
tient's surgery, the visiting hours, and the 
number of visitors allowed. They are 
assured that the surgeon will talk to them 
shortly after the surgery, and that they 
may visit their relative within a few hours 
of the operation. 

Circulatory assesment 

Postoperatively, the nursing objective 
is to maintain the patient's circulatory, 
respiratory, and neurological status. 
Checking of the vital signs - blood 
pressure, apical rate, respiration, central 
venous pressure - is the first task. In our 
intensive care unit, we record blood 
pressure with the sphygmomanometer 
and apical rate with a stethoscope. 

Direct observation of the patient's 
skin, lips, and nail-bed color is important. 
A nurse's ability to observe, perceive, and 
report the slightest change is invaluable if 
prompt treatment is to be given. An 
electronic monitor, which reports electro- 
THE CANADIAN NURSE 35 



encephalograms and arterial pressure, 
helps the nurse in her observations. 

Obviously the nurse must have a fair 
amount of knowledge about the monitor- 
ing equipment. She has to learn about the 
basic arrythmias and be able to recognize 
their appearance on the oscilloscope. Pre- 
mature ventricular beats, atrial flutter, 
atrial fibrillation, ventricular tachycardia, 
and bundle branch block are common in 
patients having valves replaced or a mitral 
valvotomy. Patients with pacemakers im- 
planted have to be observed carefully for 
irregularity in pattern and the develop- 
ment of heart block. The sensitivity of 
arterial pressure monitoring assists the 
nurse with the critically ill patient in 
whom blood pressure readings are 
inaudible. 

Fluid balance 

Chest drainage is recorded frequently 
to determine the need for blood replace- 
ment. The nurse has to be aware of the 
acute problems of hemorrhage and 
cardiac tamponade, and should correlate 
the observations of vital signs and chest 
drainage. 

Central venous pressure is an excellent 
indication of hypo - or hypervolemia. 
Measurement of central venous pressure is 
accomplished via a catheter that leads 
from a median cubital vein to the 
superior vena cava and right atrium. A 
rise in CVP is reported immediately since 
it generally indicates that the patient's 
circulatory system is being overloaded 
with excess fluid. Overloading increases 
the work of the heart, which may be un- 
able to cope with this added stress. 

Urinary output is decreased in the 
early postoperative period as the en- 
docrine response to stress of surgical 
trauma, described by Selye, includes the 
increased production of an antidiuretic 
hormone, ADH. ADH controls water 
absorption in the tubules; it is a posterior 
pituitary hormone. Output is recorded to 
evaluate the functioning of the patient's 
renal system. An output of less than 20 
cc. an hour is reported promptly. Specific 
gravity is measured every eight hours to 
determine if the concentration of the 
urine being produced is adequate. De- 
creased urinary output may be the result 
of hypovolemia, hypotension, or renal 
shutdown. 
36 THE CANADIAN NURSE 




The vital signs are the first task after heart surgery. Modern equipment in intensivi' 
care wards helps the nurse record quickly, accurately, and efficiently. 



Respiratory evaluation 

Most patients having open heart sur- 
gery will return to the unit with an endo- 
tracheal tube in place. This is connected 
to a respirator, such as the Mark VII, 
Bird, or Engstrom. Secretions are 
suctioned frequently from the tube to 
maintain a clear airway and prevent 
aspiration into the lungs. Sputum and tra- 
cheobronchial aspiration specimens are 
sent to the laboratory routinely for cul- 
ture. 

Patients are encouraged to deep 
breathe and cough every hour, and 
maximal inflations are done with an 
Ambu bag to inflate the lower lobes of 
the lungs. The nurse measures tidal 
volumes every hour to determine the 
volume of air being expired with each 
breath. The anesthetists in our unit prefer 
to maintain a volume of over 300 cc. 
when a patient is on a respirator. Inter- 
pretation of this information in relation 
to respiratory rate and total amount of 



air expired in one minute is an importan 
observation. The patient may be hyper 
ventilating to obtain an adequate amoun 
of air. 

Blood samples are drawn from ar 
indwelling arterial catheter at specifu 
times for calculation of the arterial blooc 
gases. This catheter is kept patent b) 
flushing it with a heparinized saline solu 
tion. Measurement includes the pH, p02 
C02, 02 saturation. 

The nurse watches for any change ir 
blood gas content that would indicate res 
piratory distress. Her observations includt 
increased respiratory rate, restlessness 
labored respirations, anxiety, and ; 
change in level of consciousness. (Foi 
complete discussion of blood gases anc 
their significance, see "Blood Gases" b\ 
C. Betson, the Canadian nurse Sep 
tember 1968.) 

Evaluation of neurological status 
The patient admitted to the intensive 
JANUARY 196' 



care unit following heart surgery is 
observed for response to verbal and physi- 
cal stimuli. This neurological evaluation is 
important because of the possibility of 
cerebral embolism during open heart sur- 
gery. Air not completely evacuated from 
the left ventricle prior to closure may 
result in an air embolism. Also, calcium 
or fibrin can be dislodged from the 
calcified valve and cause an embolism. 
These observations are continued 
throughout the patient's stay in the unit. 

It is necessary also to evaluate the pa- 
tient's response to time, place, and 
person. Motor ability can be tested by 
asking liim to grasp the nurse's hand and 
move each extremity independently. Sen- 
sory response of the extremities to touch 
and pain is another important obser- 
vation. 

Physical comfort of the patient is 
assessed frequently as pain wUl prevent 
him from coughing and deep breathing 
adequately and can also be a cause of 
hypotension. Analgesics are prescribed by 
the surgeon; the drug most commonly 
used in our unit is Pantapon Hydro- 
chloride 2 mg. per cc. of solution, given 
intravenously as necessary. 

The patient may respond adversely to 
narcotics if he is in shock, has renal im- 
pairment, or decreased pulmonary func- 
tion. For tliis reason, the nurse is aJert for 
any signs of toxicity caused by drug 
administration. At the same time, she 
knows that delay in administering anal- 
gesics will decrease their effectiveness. 

Physical comfort can also be achieved 
by basic nursing measures. A daily bath is 
given to all patients as their body temper- 
ature is elevated postoperatively and they 
often perspire profusely. A flannelette 
sheet used as a drawsheet is less likely to 
cause skin irritation when a patient needs 
many changes of linen. Turning the pa- 
tient frequently adds greatly to his com- 
fort, particularly if a soothing back rub is 
given at the same time. 

Emotional support 

The underlying fear of all patients who 
have had cardiac surgery is the knowledge 
that death may be just a few heart beats 
away. Added to this fear is the strange 
bewildering experience of the intensive 
care unit environment at a time when he 
is least able to cope with this additional 
lANUARY 1%9 



stress. The patient will naturally look to 
the nurse for support and understanding. 
The unusual behavior seen in an in- 
tensive care unit may be attributed to 
both physical and psychological com- 
plications. Metabolic disturbances, drug 
reactions, and electrolyte imbalance may 
lead to disorientation, visual, or auditory 
hallucinations. For example, the first in- 
dication of respiratory failure may be 
confusion and restlessness. 

The effect of the environment of the 
unit and the intensified nursing measures 
on patient behavior cannot be ignored. 
The activity in the intensive care unit is 
often at a high level, day and niglit. Chest 
routines, monitoring, and hourly observa- 
tions of vital signs all are required on a 
24-hour basis. A day-night routine is 
difficult to establish with the acutely ill 
patient and exhaustion soon leads to 
bizarre behavior. 

Studies of an open heart recovery 
room by D.S. Kornfeld* have demon- 
strated that patients may experience any- 
thing from perceptual illusion to auditory 
and visual hallucinations. Disorientation 
to time and place has been noted in many 
patients. 

Relatives also may be reassuring for 
the patient. A short visit with a loved one 
provides contact with his personal world. 
Often a cup of tea held by a wife is more 
willingly taken by the patient. 

The nurse must remember the pa- 
tient's need for privacy when attending to 
his care. Often, he is embarrassed by his 
complete helplessness and dislikes being 
exposed unnecessarily. 

To summarize, the monotony and 
timelessness of the unit, the limitations 
placed on the patient's movements by 
monitoring equipment, and arterial and 
venous pressure lines all appear to con- 
tribute to the changes seen in patients 
during their stay in the unit. Therefore, 
the nurse has to recognize tliese 
psychological changes and be prepared to 
help the patient cope with them. Without 
respect for the dignity of the individual, 
the nurse becomes a technician - skilled, 
but unable to give her patient the "tender 

* D.S. Kornfeld, S. Zimberg, and J. Main, 
Psychiatric complications of open heart sur- 
gery. New England J. Med.. 273:287-292, 
August 1965. 



loving care" so necessary in this unit. 

Simple measures help 

Wliat can a nurse do to provide com- 
fort and relief from anxiety for the 
patient? Often the simplest measure is 
enough. Turning the pillow over, 
remembering to put a little ice in the 
drink, placing a pillow at his back while 
he is sitting at the side of the bed. giving a 
back rub that reaches the aching muscles. 
These basic nursing measures, combined 
with a warm smile and a soothing voice, 
do much to make the patient feel at ease. 

With the era of cardiac transplants 
now here, nursing will be faced with new 
challenges for the refinement of special- 
ized skills and techniques. The unique 
contribution of the nurse in the care of 
the heart patient must keep pace with the 
advances in surgery. 

Bibliography 

Bordicks, Katherine J. Patterns of Shock Im- 
plications for Nursing Care. Toronto, Mac- 
millan, 1965. p.7-40, 64-135. 

Braimbridge, M.V. and Ghadiali, P.E. 
Postoperative Cardiac Care. O.xford, Eng. 
Blackwell Scientific Publications, 1965. 
p.9-17, 26-35. 

Gurd, F.N. Pathogenesis and treatment of 
shock. Canad. Nurs. 62:33-37, Oct. 1966. 

Modell, Walter, et al. Handbook of Cardiology 
for Nurses. New York, Springer, 1966. 

Nett, Louise M., and Petty, T.L. Acute respira- 
tory failure. Amer. J. Nurs. 67:1847-1853. 
September 1967. 

Powers, Mary Ann E. and Storlier, Frances. The 
apprehensive patient. Amer J. Nurs. 
67:58-63, January 1967. D 



THE CANADIAN NURSE 37 



A new category 
of health worker for Canada? 



Medically trained people, known as 
"physicians' assistants" or "medical 
assistants, " have recently been employed 
in certain areas of the United States to 
relieve doctors of much of their routine 
work. At Duke University. North 
Carolina, a two-year course of training 
was initiated, which prepared, as phy- 
sicians' assistants, people who had a 
medical background but who lacked the 
opportunity or academic qualifications to 
become doctors. The Duke trainees have 
mostly been medical corpsmen. Their 
duties have included such tasks as taking 
histories, drawing blood, collecting 
specimens for gastric analysis, doing basal 
metabolism rates, electrocardiography, 
and skin-testing for allergies. A t Denver, 
Colorado, "nurse practitioners" have 
been trained to take on comprehensive 
well-child care and to identify and refer 
chronic conditions. Other institutions in 
the United States are following this lead. 
In Russia the feldshers have, for many 
years, been acting as doctors' assistants. 
In Europe trained midwives often serve 
similar functions. 

Should Canada also train and employ 
such people? Is there a need for them 
here? If there is a need, would nurses 
suffer by the introduction of a new class 
of worker? Would it be better if nurses 
gave the necessary assistance to phy- 
sicians? 

THE CANADIAN NURSE Sent thc 

author, a freelance writer and researcher, 
to interview some of our doctors and 
nurses who have expressed strong 
opinions on this controversial subject. 
Their views are given here. 
38 THE CANADIAN NURSE 



Carlotla L. Hacker, M.A. 

Dr. J. B. R. McKendry is convinced 
that there is a real need for physicians' 
assistants in Canada, first because of the 
demand for primary contact medical 
people, and second because a fairly high 
proportion of medical troubles are rela- 
tively easy to manage. He believes that 
with a situation of too many chiefs and 
not enough Indians, it is at present the 
chiefs who are spending much of their 
time doing simple repetitive tasks. 

"It's a waste of physicians' training," 
says Dr. McKendry. "it's demeaning for 
them to be doing these tasks, and it's ex- 
pensive for society to have them do 
them." 

Dr. McKendry, who is Chief of the De- 
partment of Metabolism at the Ottawa 
Civic Hospital, feels that, in his own case, 
he could quickly train a person to be of 
enormous help to him in managing the 
large numbers of patients who have un- 
complicated diabetes and in handling the 
straightforward routines. 

"A doctor is limited now in what he 
can do in a day by the fact that he's only 
got two hands, two eyes, and 24 hours. 
But he could almost double his effective- 

Carlotta Hacker is an English and History 
graduate of St. Andrews University in Scotland. 
Her writings include articles and short stories 
for Pan Boolcs, London's Observer, The 
Cornhill Magazine, and for the Blue Cross 
periodical Blue Gold. In 1965 she contributed 
an article to THE CANADIAN NURSE on the Can- 
adian Medical Expedition to Easter Island. Her 
book, ... And Christmas Day on Easter Island 
has recently been published by Michael Joseph 
Ltd. of London, England. 



ness if he had someone who would take 
off his hands the repetitious mix of work 
that inevitably is found with his more de- 
manding cases. Then he would not only 
have the time, but also the energy, to deal 
effectively with these more demanding 
cases." 

Dr. McKendry does not think that a 
nurse, as such, would fully answer these 
requirements. What he would like to see 
is the creation of a new category of 
worker who would work for the phy- 
sician on a straightforward, employer- 
employee basis and be paid by the phy- 
sician. And he would prefer this person to 
be called practitioner-associate rather 
than physician's assistant. "This might 
then be shortened to practitioner," he 
says, "and then the doctors would prop- 
erly retain their own title as doctors." 

The fact that Dr. McKendry has views 
even on the name for these people is 
some indication of the thought he has 
given to this category of worker. He has 
already written a number of papers on 
the subject, he has studied the courses for 
physicians' assistants offered at Duke 
University and at Colorado, and he has 
visited Russia and observed the feldsher 
training facilities there. The result is a 
clear idea of how practitioner-associates 
could be introduced into Canada. 

He suggests the following as a possible 
program. 

The position of practitioner-associate 
would be open to nurses, to ex- 
servicemen with medical experience or to 
any other group with some medical 
knowledge, and to high school graduates. 
It would require a four-year course, al- 
lANUARY 196S 




Dr. J. B. R. McKetjdry: "Maybe the ambitious vanguard of nurses should be pulling off 
and going into a new cadre of professionals. 



though previous work in medicine or 
nursing could count as credits and could 
shorten the course. The course itself 
should be sponsored by a university in 
affiliation with hospitals, clinics, and 
doctors' offices for practical training. 

The first three years would concen- 
trate on classroom and laboratory work 
and would be in an institute attached to a 
university. Dr. McKendry believes that 
many universities would be glad to form 
such institutes, particularly those uni- 
versities that at present are unable to 
open full-scale medical schools because of 
financial and practical difficulties. The 
fourth year would be devoted entirely to 
clinical and specialized training in the 
appropriate field. For example, a 
practitioner-associate who was preparing 
to work under an obstetrician as a trained 
midwife would take his final year in a 
department of obstetrics. 

Having successfully completed his 
course, the practitioner-associate would 
receive a diploma and a license permitting 
him to practice in the area in which he 
had trained, under the supervision of a 
doctor, and on a one-to-one basis with 
the doctor. 

Dr. McKendry stresses the importance 
of this one-to-one basis. He does not 
intend that a doctor should employ more 
than one assistant, partly because a good 
working relationship is easier to establish 
with one person than with a group, and 
partly because supervision is easier. And 
supervision is essential as the physician 
would be morally and legally responsible 
for the actions of his assistant. An Act of 
Parliament would be necessary to 
stipulate tiie legal responsibilities of 
practitioner-associates and the physicians 
who employed them. 

With regard to finance, Dr. McKendry 
lANUARY 1%9 



suggests that the practitioner-associates 
should be subsidized during training, just 
as medical students are being subsidized 
at present. 

"The country can afford this much 
more readily than it can afford to double 
the number of MDs," he says. 

After training, the assistants would be 
paid by the doctors who decided to em- 
ploy them. Renegotiation of contract 
every two years should be a basic princi- 
ple. This, together with the good 
employer-employee relationship which is 
envisaged, would minimize possible 
agitation from a practitioner-associate's 
union, for it would enable a really com- 
petent practitioner to command a salary 
equivalent to the value of his work. 

There should be no ceiling to this cate- 
gory: if an assistant were to prove he had 
the ability of a potential MD, then he 
should be permitted to enter medical 
school, counting his diploma as a credit 
toward his medical degree. 

But how are nurses going to feel about 
all this? Well, by this scheme, they would 
also be given the chance of mobility, 
according to Dr. McKendry. 

"And such nurses as might resent the 
creation of practitioner-associates are 
probably the very nurses who should try 
to qualify for the position," he suggests. 
"Maybe the ambitious vanguard of nurses 
should be pulling off and going into a 
new cadre of professionals. Then the 
other nurses could get back to nursing." 

How will the patient feel? "By and 
large, 1 think that when a doctor, in 
whom a patient has trust, designates 
someone else as his replacement or 
assistant, then the patient accepts this, 
knowing that if he is very sick or if there 
is some great emergency, then the doctor 
is available and will be called." 



What about computers and electronic 
aids? Mightn't we soon find that 
machines could replace assistants in much 
of their work? 

"We are all equipped with computers 
in our heads that are vastly superior to 
any computer that can be envisaged in 
the next century," Dr. McKendry 
answered. "There may be a little help 
from electronic communications, but 
they, too, depend on what's fed into 
them." 

On all counts. Dr. McKendry is con- 
vinced that a new category of worker is 
the solution to the problem of the over- 
worked physician. 

"Without something like the approach 
that I'm describing," he says, "we won't 
begin to meet the need for primary 
contact personnel in this country in this 
century." 



"The primary contact person - the 
person who is to see the patient and 
decide what is wrong with him - should 
not be anything less than a doctor." 

In this statement. Dr. A. L. CHUTE is 
referring to normal conditions where a 
doctor is available - not to isolated parts 
of Canada. He does not think that in 
normal circumstances an assistant should 
be responsible for deciding which patients 
require the attention of an MD. 

But it is not only in primary contact 
work that Dr. Chute opposes the idea of 
physician's assistants. He questions the 
need for them at all in Canada, mainly 
because he questions whether there really 
is a shortage of physicians here. 

"And unless you predicate a shortage 
of physicians, there isn't any reason to 
say that there should be physicians' assist- 
ants," he argues. 

With many years of experience as 
Chief of Pediatrics at Toronto's Hospital 
for Sick Children, with medical wartime 
service, with teaching experience at the 
University of Toronto as Professor of 
Pediatrics, and now as Dean of Medicine, 
Dr. Chute's interests range over a wide 
spectrum of medical subjects. His 
reaction to the present subject is to ques- 
tion whether perhaps medicine is suffer- 
ing from a distribution problem rather 
than from an actual shortage of phy- 
sicians. 

"We provide training posts for people 
indiscriminately," he says. "We are train- 
ing three or four times as many surgeons 
as we need. If we reduced the number of 
training posts for surgeons and made 
more training posts available for other 
people, then we might redirect our 
qualified manpower into more effective 
areas." 

Similarly, Dr. Chute believes that if 
the position of the family doctor were 
made more attractive - for instance, by 
the formation of group practices, so that 
a genera] practitioner would know that a 
weekend off work really was a weekend 

THE CANADIAN NURSE 39 




Dr. A. L. Chute: "I don't think there's any necessity for creating a new breed of cats." 



off - then this, too, might direct doctors 
into more needed areas. 

But even if there does prove to be a 
shortage of physicians, Dr. Chute does 
not like the idea of creating a new 
category of worker, because another cat- 
egory would splinter everything further. 
There would be new union problems and 
another group of people worrying about 
their rights and privUeges, without the 
end purpose - patient care being 
accomplished. 

"No," he says. "I don't think there's 
any necessity for creating a new breed of 
cats." 

Dr. Chute would far rather see a draw- 
ing together of the existing ranks of 
health workers, a drawing together into a 
team approach aimed toward the welfare 
of the patient. He believes that present 
gaps in medical care could be filled by a 
better use and a more appropriate train- 
ing of the people already available. He 
points out that for years nurses have been 
performing much of the work that the 
medical assistants at Duke University list 
in their duties. Where necessary, they 
could take on more. 

In other words, specialize the nurse. 
Break free from the thesis that "a nurse- 
is-a-nurse-is-a-nurse and they all get paid 
the same." Let nurses, who have the 
ability and the desire to do so, take a 
40 THE CANADIAN NURSE 



course of training for some particular job. 
But let them, like specialist doctors, 
receive recognition and financial rewards 
for their extra training. And, just as 
specialist doctors are still in fact doctors, 
let specialist nurses remain nurses. There's 
no reason to call them anything different. 
"This is the real answer," says Dr. 
Chute. "Nursing has to be specialized, 
and then automatically you've got your 
doctor's assistant." 



MLLE Julienne Provost and Mlle 
Mariette DESJARDINS see things 
otherwise; a nurse is a nurse, and she 
should in no way aspire to be a little 
doctor. 

Sitting in their office at the University 
of Montreal, these two Assistant Pro- 
fessors of Nursing eagerly discussed the 
advantages and disadvantages of intro- 
ducing doctors' assistants into Canada. 
They look neutrally on the suggestion, 
seeing the assistant as being neither super- 
ior nor inferior to the nurse: like the 
social worker, he or she would simply be 
something different. However they would 
not wish the physician's assistant to be 
recruited from the nursing staff, any 
more than they would wish a nurse to fill 
much the same function by becoming 
over-specialized. 

Mlle Provost is particularly concerned 



about the fonction independante of the 
nurse: her true role in caring for the 
patient. If the nurse is to be entirely 
removed from this, either as a specialist 
nurse or as a physicians' assistant, then 
she would no longer be following her 
vocation. Even a clinical nurse should 
remember ttiat she is primarily a nurse 
and should see that something of this role 
is retained. 

But, as Mile Desjardins pointed out, if 
there were more clinical or specialist 
nurses they probably could take over the 
assistant physician's functions while pre- 
serving their independent function, as 
shown in the Colorado University experi- 
ment. But, if the physician's assistant 
were recruited outside nursing, and if he 
were to take over some non-nursing work, 
then it could return nurses to nursing. 

However, both instructors are aware of 
the possible problems: How will the 
cUnical nurse feel about the creation of 
this new category of worker? Will she 
feel threatened by it? And who will be 
responsible for physicians' assistants who 
are working in a hospital - the doctor or 
the hospital administrator? Will assistants 
give orders to nurses and, if so, will nurses 
be obliged to obey the orders? They 
should be licensed, but they may be 
difficult to control if they are licensed. 
How will the public be protected? 

Mile Provost and Mile Desjardins 
would like to see a survey conducted that 
would answer these questions and would 
evaluate the need for such assistants in 
Canada. One can learn a certain amount 
from the experiment in the United States, 
but physicians' assistants there, particu- 
larly at Duke University, are fulfilling 
specific needs, one of which is the em- 
ployment of medically-trained ex- 
servicemen. So they suggest that an 
opinion poll should be taken among our 
own doctors, specialists, and clinical 
nurses; that a research project be started 
and that some experiments be made here 
to see how such assistants would fit the 
Canadian needs. For both Mlle Provost 
and Mlle Desjardins do feel that physi- 
cians' assistants might well serve a useful 
function within medicine in Canada, 
provided they are introduced carefully 
and with vigilance. 



ALBERT WedgERY does not share 
this view. Although he believes that there 
is a need for an assistant to the doctor, he 
is not by any means convinced that this 
means creating a new category of worker. 

"It's all very well to say: 'we need an 
assistant so we'll set up a new category of 
worker,' but every time you create some- 
thing new, you have to live with it." 

Mr. Wedgery can foresee a host of 
problems that will have to be lived with if 
physicians' assistants are introduced into 
Canada. Inevitably there will be the form- 
ation of unions pressuring for higher 
lANUARY 196" 




Mile J. Provost: "Physicians' 
medicine in Canada. " 



assistants might well serve a useful function within 



Mile M. Desjardins: "If the physicians' assistants were to take over some of the work 
presently being done by nurses, it could help to return nurses to nursing. " 




salaries and for a stronger position within 
medicine. There will be legal difficulties, 
particularly if, as in the United States, the 
assistants are not licensed. And then there 
is the matter of control: the assistants 
might be able to set up on their own, 
charging what fees they liked and func- 
tioning as they liked, unless they were 
registered with some organization that 
could control them. 

"And I have a feeling," he says, 
"though I may be entirely wrong, that 
this whole medical assistant thing is a 
stop-gap, that it's abortive. 

He suspects that it wouldn't be long 
before, physicians' assistants wanted to go 
further in medicine, and the only future 
he can see for them is that they should be 
allowed to use their experience as credits 
toward entering medical school. In which 
case, unless a very large number of assist- 
ants were trained, we would be back at 
stage one, with doctors needing helpers. 

As President of the Registered Nurses' 
Association of Ontario and as one who 
has considerable experience in nursing, 
Mr. Wedgery is naturally concerned about 
the effect the formation of this category 
would have on nurses. He fears that 
physicians' assistants could potentially 
separate the nurse from the doctor. He 
also fears that they might remove from 
the nurse's duties such procedures as 
starting iiitravenouses and taking blood 
pressures. While he is certainly not 
suggesting that nurses should take over 
medical practice, he would like the 
medical procedures that have been per- 
formed competently by nurses for a long 
time now to be recognized as nursing 
practice and placed in the nursing curricu- 
lum. For he feels strongly that whatever 
brings the nurse closer to the patient can 
become part of nursing. 

"Otherwise," he says, "if the bulk of 
nursing is going to be done by nursing 
assistants and the medical procedures 
done by the physicians' assistants, then 
what are the nurses going to have left to 
do? We can easily find ourselves in 
danger of isolating ourselves - like 
painting ourselves into a corner." 

Specialization will have to come. This 
Mr. Wedgery recognizes as inevitable. 
Even so, he would like to see a return to 
total patient care, and some move could 
be made toward this if it were nurses who 
were to give the necessary assistance to 
the physicians. 

"It seems to me that, because of the 
background of nurses, because of their in- 
timate daily and hourly contact with the 
patient, there is no reason why nurses - 
probably specially trained over and above 
the normal nurse's education - should 
not be doing these tasks." 



» lANUARY 1%9 



"I think that there is a need for 
physicians' assistants in Canada and 1 
think that, if the scheme is developed 
well, it may be a very good thing. 

THE CANADIAN NURSE 41 




A. Wedgery: "Every time you create something new, you have to live with it. " 



Margaret McLean, Senior Nursing 
Consultant, Hospital Services Branch, De- 
partment of National Health and Welfare, 
settled back in her chair and stated her 
case clearly. 

First, she distinguished between the 
type of medical assistants employed in 
Colorado and the type employed at Duke 
University. She considers the former to 
be similar to clinical specialists in pe- 
diatric nursing and sees no reason for 
such people to be placed outside nursing. 
But the situation at Duke University is 
different. The people there are not per- 
forming as nurses. They are assistants to 
the doctors and therefore they should be 
classed as such. 

Miss McLean sees the physician's 
assistant as being just that: his assistant. 
Not someone who does a little bit of 
nursing and a little bit of laboratory work 
and so on, although he may bring some of 
the nurse's present jobs back into medical 
practice. "After all, is it nursing to draw 
blood from a vein? " Miss McLean asked. 
The assistant's main purpose will be to 
relieve the doctor of much of his routine 
work, including primary contact work. 
However, he must not be allowed to 
come between the doctor and the other 
health professionals, such as nurses, 
dietitians, and physiotherapists. 

From the legal and practical points of 

42 THE CANADIAN NURSE 



view, Miss McLean feels that the doctor 
will have to take responsibility for the 
work of his assistant, and the assistant 
will have to be licensed. The alternative — 
that of licensed nurses being given further 
training in special subjects - would not 
produce the type of person that is 
required, for nurses have additional func- 
tions and additional loyalties. The result 
could be an uneasy compromise and yet 
another "grey area." 

But of course nurses could train to 
become medical assistants, if they were 
prepared to leave nursing. 

"Some nurses would like to be doctors 
and they might see this as a status thing," 
says Miss McLean. "But it wouldn't 
attract me! " 

She does not foresee any great 
depletion in the nursing force by the 
creation of this new category, nor does 
she think that it should give rise to 
rivalries. "The nurse who Hkcs caring for 
the patient is not the one who is going to 
become a medical assistant." 

For the training of the physician's 
assistant, Margaret McLean inclines 
toward a two-year course, althougli it 
miglU have to be longer; this would have 
to be decided by the medical profession. 
She is conscious tuat the success of the 
experiment will depend very much on 
how it is handled and how controlled. 



and therefore she suggests that only a few 
medical assistants should be taken on 
initially. The curriculum could then be 
modified, where necessary, with the next 
group of trainees. 

One thing she would like to see clearly 
defined at the outset is the role of the 
physician's assistant - just as she would 
like there to be a clear and mutual under- 
standing of the roles and objectives of all 
other health workers. If this can be 
agreed harmoniously among doctors and 
nurses, and understood by the assistants 
themselves, then she feels that the intro- 
duction of tliese assistants into medical 
practice could be of great benefit to 
Canada. 

"I don't believe that just because 
something is right for one country, it's 
automatically operationally right for 
another country,'' said 
Dr. Shirley Good firmly. "You have 
to look at the needs, you have to look at 
the distribution of population, and I 
question seriously whether we need 
another kind of health worker: one more 
person who will come between the physi- 
cian and the patient and health care." 

Looking at Duke University, for 
instance. Dr. Good, who is Consultant in 
Higher Education, Canadian Nurses' Asso- 
ciation, can see an identified need for 
physicians' assistants there and she can 
see that there is a large number of 
medical corpsmen available to fill the 
need. But Canada does not have the same 
manpower problem as the United States, 
nor does Dr. Good feel that our physi- 
cians necessarily require similar 
assistance. 

"1 don't think we have a shortage of 
physicians or a shortage of nurses, but I 
do think there is a shortage of nursing. " 

If nurses were to extend their abilities 
to give greater nursing care and if capable 
nurses were given more latitude to 
develop their skills, then nursing itself 
could be improved and the existing void 
between the work of doctors and nurses 
could be filled. So, although Shirley 
Good does not hold that we should copy 
tlie pediatric program at Colorado, she 
could view with equanimity something 
like that happening here, if it proved to 
be necessary, as the Colorado students are 
registered nurses taking further training 
for a specific purpose. 

But, to create a whole new category of 
worker: No! 

Why should we? asks Dr. Good. Have 
we proved that it is really necessary? If 
far more use were made of existing tech- 
nical aids and more use made of the 
resources within the nursing profession, 
then we shouldn't require another 
worker. 

In any case, who would license physi- 
cians' assistants? To whom would the 
licensure fees be paid? If, like other 
groups, they licensed themselves, would 
JANUARY 1969 




r 



M McLean: "Some nurses would like to be doctors and they might see the physicians' 
assistant role as a status thing. " 



Dr. S. Good: "Just because something is right for one country, it's not automatically 
right for another " 




they then demand to be a profession in 
their own right and begin to fight physi- 
cians? If, on the other hand, physicians 
licensed them, then presumably the 
physicians would be legally responsible 
for them. If this were so, or if the assist- 
ants were unlicensed, would the physician 
responsible lose his license if something 
happened to the patient? And where 
would these workers get their code of 
ethics? 

Another point Shirley Good raised 
was: Who will pay physicians' assistants? 
It's all very well to say that doctors will 
provide the salaries, but will a doctor 
really be prepared to accept such a large 
drop in his own income? It could 
amount to $10,000 a year or more. If the 
government pays, then up goes the 
medical insurance. 

There is the possibility, too, that we 
could be making work rather than 
reducing it, for someone will have to 
teach these people. Will it be doctors who 
do so? 

Dr. Good was also concerned about 
the effect such a category of worker 
might have on the nursing profession. It 
could push nurses back both financially 
and psychologically so that they found 
themselves in the position of nurses' aides 
or nursing assistants. 

She would far prefer to see nurses 
themselves being given the chance to 
branch outwards so that those who 
wished could take on more clinical and 
technical work. 

"You see, the nurse, if specially train- 
ed, can bring with her into technical work 
the kindness and humanness that is her 
unique function. And a thoroughly 
educated person in a balanced educa- 
tional center should be capable of 
bringing this sensitive approach to patient 
care in an age of technology." D 



JANUARY 1%9 



THE CANADIAN NURSE 43 



idea 
exchange 



How Much Bleeding? 

When a doctor is called to the tele- 
phone, whether it be day or night, and 
whether he be an intern, resident, fam- 
ily physician, or specialist, and he is 
told that a patient is "bleeding heav- 
ily," that information should have a 
specific meaning. 

Often it is extremely difficult for a 
nurse to communicate to the doctor a 
reasonable conception of the amount of 
bleeding. Uncertainty on his part re- 
sults in wasted visits to see patients 
who are not actually bleeding exces- 
sively, as well as the anxiety that en- 
sues when he is unable to make these 
visits immediately. 

To avoid these difficulties, a system 
was developed 15 years ago that has 
been used in our hospital ever since. 

Three perineal pads are prepared. 
Onto the first one, 10 cc. of blood is 
dropped from a syringe, 30 cc. onto 
the second, and 60 cc. onto the third. 



These three pads are then laid side by 
side with a card under each showing 
the amount of blood, and a color pho- 
tograph is taken. This picture is en- 
larged to eight inches by ten inches and 
used in the nursing school and on each 
female ward as a ready reference. 

Since this system has been used, the 
nurse has been able to report with rea- 
sonable accuracy that "the amount of 
blood is about 50 cc. per hour" or 
"the blood amounts to 10 cc. on a pad 
that has been in place for two hours." 

This system can be put into use in 
any hospital prepared to spend a few 
dollars for photographs and will elim- 
inate a great deal of aggravation and 
unnecessary effort. 

Incidentally, the word "saturated" 
should be avoided, or used only to in- 
dicate that the pad drips from one end 
when help up by the other. — Mi- 
chael Bruser, M.D., F.A.C.O.G., Mi- 
sericordia General Hospital, Winnipeg. 




44 THE CANADIAN NURSE 



Keep The Private Duty 
Directories Running 

Recently we learned that memoers 
of some Private Duty Registries or Di- 
rectories have encountered a problem 
similar to that faced by our members 
in 1966, and we thought that informa- 
tion about the way we solved our prob- 
lem might be helpful. 

In November, 1965, the Registered 
Nurses' Association of British Colum- 
bia notified the Victoria Private Duty 
Registry that RNABC could no longer 
provide financial support for the Regis- 
try after March 1, 1966. Immediately, 
the private duty nurses appointed a 
committee to explore ways and means 
of replacing the former registry to con- 
tinue to provide a central service for 
private duty calls from the public, phy- 
sicians, and hospitals. 

A questionnaire was sent to many 
Private Duty Registries across Canada 
through the provincial registered 
nurses' associations to learn how they 
functioned. Many replies were received 
and the information thus obtained was 
carefully studied. 

After careful consideration the pri- 
vate duty nurses decided to establish an 
unincorporated association — The 
Victoria Private Duty Registered (B. 
C.) Nurses' Directory. 

Bylaws were drawn up and present- 
ed to the members. Receipt books 
were prepared, and officially adopted 
for use by directory members only. Ar- 
rangements were made with a local 
telephone answering service for 24- 
hour answering service coverage, in- 
cluding week-ends and statutory holi- 
days. A Kardex system was prepared 
for the answering service office, listing 
names of available nurses, phone num- 
bers, and preferred hours and type of 
work. 

In February 1 966, cards were sent to 
doctors, major hospitals, and also pri- 
vate hospitals. Lists of current members 
of the Victoria Duty Registered (B.C.) 
Nurses' Directory were sent to depart- 
ments of nursing service of the major 
hospitals. 

We also notified the press, and re- 
ceived good publicity about the new 
Directory. 

March 1, 1966, the "change-over" 
proceeded smoothly. The Directory has 
functioned satisfactorily for almost 
lANUARY 1969 



three years now. 

The Executive Committee, which as- 
sumes responsibility for the Directory 
is appointed by the membership and 
consists of a president, a vice-presi- 
dent, treasurer, recording secretary, 
and registrar. Salaried stafl is not em- 
ployed nor an office maintained (other 
than the telephone answering service 
office). The registrar maintains the 
Kardex for the telephone answering 
service and the lists for the hospital 
nursing service departments. 

Services of the executive members are 
on a voluntary basis, but the registrar 
receives a small honorarium to reim- 
burse her for expenses incurred during 
the year. 

Nurses who wish to join the Direc- 
tory must be current members of the 
RNABC and also complete a com- 
prehensive application form. The fee 
for registration with the Directory is 
$20 a year or a semi-annual fee of 
$10. Each member must obtain a copy 
of the official bylaws and agree to 
abide by them. Official receipt books 
are supplied; there is a small charge 
for these booklets. 

Fees to the patient are presently $20 
for an eight-hour shift, however these 
fees will be reviewed when so indicat- 
ed. 

Rapidly changing trends in nursing 
make it necessary for private duty 
nurses to keep abreast of changes. The 
Directory's regular monthly meetings 
help in this way, and arrangements 
have been made for the members to at- 
tend inservice classes and lectures at 
the major hospitals. Refresher courses 
at the University of Victoria and the 
University of B.C. are also available 
for our members. 

The Directory has been working 
satisfactorily, is in sound financial con- 
dition, and the telephone answering 
service provides the private duty nurses 
with an interested and efficient service. 
We find that our cooperative effort has 
worked. Other Directories who would 
like more information should write to 
the President, Mrs. M. Fitzgerald, 966 
Hampshire Rd., Victoria, B.C. — Ja- 
nie E. Jamieson, R.N., Registrar, Vic- 
toria Private Duty Nurses' Directory. 



A New Desing For 
Stryker Turning Frame Covers 

A study of the nursing care of pa- 
tients on the Stryker Turning Frame 
showed the need to design special cov- 
ers. The aim was to make the patient 
more comfortable and facilitate nursing 
care. 

The covers described in this article 
are the result of many months of work 
and experimentation. They have been 
in use for a trial period and have the 
following advantages over those used 
previously. 

• The comfort of the patient is in- 
creased and it is easier to give nursing 
care. 

• The covers are all one size and can 
be adjusted to fit the different-sized 
frames. 

• Covers can be applied quickly and 
easily. 

• Covers are securely fastened and 
remain smooth and taut. 

The material used for making the 
covers is preshrunk flannelette, double 



thickness. The border on either side is 
bleached duck, which provides a firm 
edge and prevents tearing. The covers 
are applied over the canvas already on 
the frame. 

Awning cord is laced through metal 
gromets spaced at regular intervals in 
the border. The lacing holds the covers 
so that the upper surface is smooth 
and taut. The size of the cover can be 
adjusted to fit the frame by folding it 
under at the head and/or foot. Several 
rows of stitching inside the border pre- 
vent the flannelette from tearing when 
the stabilizers are being put into place. 
Valero closures are used on the covers 
for the forehead, arm, and foot sup- 
ports. 

The cover was such a success that 
we submitted the design to a local 
company. It has taken a copyright on 
the product and will be selling sets of 
covers (see "New Products," page 22 ). 
— Jessie F. Young, Supervisor, Neu- 
rosurgical Nursing, Toronto General 
Hospital, Toronto. D 




JANUARY 1969 



THE CANADIAN NURSE 45 



research abstracts 



Peterson, Alva L. A study to determine - is 
the nurse in a double-bind when caring for 
patients on isolation care? Montreal, 1968. 
Thesis (M.Sc.N.(A)). McGill. 

The study is concerned with the nurse's 
approach to caring for patients on isolation care 
in single rooms on a medical or surgical nursing 
unit. To test the hypothesis that a nurse in this 
situation is in a double-bind, a comparison has 
been made of her approach to caring for 
patients under two situations: isolation and 
protective care. Both of these situations require 
the performance and maintenance of barrier 
nursing techniques - nursing measures 
necessary to prevent the transmission of patho- 
genic organisms. 

The sample consisted of 61 third-year 
student nurses at a large general hospital school 
of nursing. A questionnaire of 35 statements 
directed toward each situation, isolation and 
protective care, was used to determine the 
nurse's assessment of her approach and the 
feelings of the patient in both instances. The 
difference between the means of the scores for 
isolation and protective care was statistically 
significant at the .001 level. The findings 
supported the hypothesis. 



Lane, Marlene A. The relationship between 
the physical adjustment of children to 
diabetes and the marital integration of their 
parents. Montreal. 1968. Thesis 
(M.Sc.N.(A)). McGill. 

This study is concerned with the 
relationship between family interaction and an 
ill member's adjustment to his disease. The 
hypothesis states that there is a positive 
correlation between the adjustment of a child 
to his diabetes and his parents' marital inte- 
gration. 

Twenty-two families were selected from the 
clinic and private files of a large children's 
hospital; the families met certain criteria 
including the child's age and family com- 
position. Twenty families agreed to participate. 

Marital integration is defined as agreement 
on family goals and lack of role tension be- 
tween the couple. This was measured by 
Farber's Index of Marital Integration, ad- 
ministered to parents in their home. Child's 
adjustment to his disea.se is defined as a lack of 
physical symptoms of poor control and was 
measured by a six-category scale specifically 
constructed for the study. The six categories 
provide for deviation from normal in areas of 

46 THE CANADIAN NURSE 



hospitalization, illness, reactions, urine tests, 
blood sugars, and growth. The data were 
collected from records in the home and in the 
hospital. 

Spearman's rho was used to measure the 
correlation between ranking of parents and 
children. 

Gross analysis of the ranking of marital inte- 
gration and child's adjustment does not indicate 
a relationship. More specific analysis shows a 
positive relationship between the child's 
physical adjustment and the lack of tension in 
his parents. This relationship is significant at 
the level of p. - less than .005. 



Quittenton, R. C. Community Colleges and 
Nursing Education in Ontario. Windsor, 
1968. 

This report was prepared with the close 
collaboration of members of the nursing pro- 
fession and hospital administrators in the area. 
It explores the need for a regional school of 
nursing in Windsor. The author recommended 
not to establish a regional school, but to 
augment the existing hospital nursing schools 
with the addition of a diploma nursing school, 
administered by St. Clair College and func- 
tioning as the core of a broad health science 
education unit. This nursing school would 
operate on a two-year program, with mature 
students constituting at least half the enroll- 
ment. The report contains comprehensive 
supporting data for this overall recom- 
mendation. 

Studies are made of post-secondary enroll- 
ments in Ontario with forecasts predicting 
increased student competition for the hospital 
nursing schools. It is shown that bedside clinical 
training time available in Windsor could support 
a total student enrollment 50 percent above the 
current level, and Ontario nursing enrollments 
could double without any increase in hospital 
beds. It points out that student recruitment is 
not limited by availability of potential students, 
student financing, hospital school places, 
clinical training time, or demand for graduates, 
but rather by admission practices, training en- 
vironment, and conditions of employment. 

Population and hospital patient-day pro- 
jections, coupled with a declining output of 
physicians in Ontario (based on a ten-year 
average proven performance a percentage 
drop three times that of the diploma nurse 
output), indicate that by 1975 an output of 
250 diploma nurses per million patient days, or 
a total output of 4,650 diploma nurses, would 



be required to maintain the overall 1955 level 
of Ontario health services. Comparisons made 
between Windsor and the rest of the province 
reveal that Windsor's output of total nursing 
personnel is about 25 percent better than the 
provincial average and the local hospital schools 
should therefore be encouraged to continue 
their outstanding performance rather than 
become incorporated into one regional school. 
Despite this superior performance, the expected 
growth of these hospital schools is inadequate 
to meet the forecast needs. For this reason a 
diploma program in the community college is 
recommended. 



Wilson, Hazel. A study to explore the 
relationship between absence events and the 
scheduling of time and work assignments of 
registered nurses and nursing assistants in 
selected units of a general hospital. 
Montreal, 1968. Thesis (M.Sc.N.(A)). McGill. 

This study explored the hypothesis that a 
relationship exists between absence events of 
nursing personnel and unsatisfactory situations 
relating to the scheduling of time and work 
assignments. 

An absence event was defined as any 
absence from work for one or two days 
duration when the individual was scheduled to 
work. 

The subjects were 177 registered nurses and 
63 nursing assistants on 23 nursing units of a 
large general hospital. The number of absence 
events of all nursing personnel who had worked 
on each nursing unit during the six-month 
period, September 1, 1967 to February 29, 
1968, was obtained from the personnel cards. 
There was a total of 982 absence events per 433 
nursing positions. 

A mean absence events score was computed 
for each nursing unit. Analysis of variance indi- 
cated that units above and below the mean 
differed significantly. 

By means of a rating-type scale question- 
naire, nursing personnel were asked to indicate 
the frequency of occurrences and extent of 
satisfaction with 10 statements each relating to 
the scheduling of time and to the scheduling of 
work assignments. A favorableness of occur- 
rence score was obtained for the items of time, 
for the items of work, and for time and work 
combined. Nursing units were assigned to 
groups above and below the mean of the favor- 
ableness of occurrence scores, and an analysis 
of variance was employed to assess the 
difference of the groups on mean absence 
events scores. 

JANUARY 1969 



research abstracts 



The hypothesis was upheld for the sched- 
uling of time but not for the scheduling of 
work assignments. 



Rheault, M. Claire, s.g. A comparison of 
students' achievement on a sequential 
learning experience with other measures of 
student progress. Montreal, 1968. Thesis 
(M.Sc.N.(A)). McGiU. 

The major purpose of this study was to 
throw more light upon the all-time problem of 
evaluating student nurses who are learning to 
nurse. Present systems of evaluation in nursing 
education tend to appraise personality traits 
rather than students' progress. It follows that 
complex behaviors pertaining to students' and 
evaluators" attitudes, opinions, and habits 
shadow more or less an objective evaluation, 
and consequently the improvement or change 
in the student nurses' performance. 

Assuming Gestalt wxiters' theory; "What 
happens to a part happens to the whole," a 
sequential learning experience called "daily 
plans for patient care" and performed by 
beginning students during the first term of 



study, was analyzed using a content analysis 
technique. The results were compared with 
other measures of progress used by the nursing 
teachers for the same students at their nursing 
school. The object was to demonstrate that 
students could be evaluated by assessing their 
progress on the DPPC. 

The hypothesis stating "Students' perform- 
ance on the daily plans for patient care is a 
reflection of her overall behavior in the school" 
had to be rejected, but the theory holds firmly 
for some of the individual measures of progress 
used by the school. Nevertheless, it is im- 
possible that the method of assigning marks on 
the daily plans for patient care, in this study, 
may have influenced the result. 



Mackenzie, Florence I. a study of the 
relationship between the information about 
the patient as a person which is recorded on 
the nursing care plan and the information 
about the same person as recorded by the 
student after nursing the patient. Montreal, 
1968. Thesis (M.Sc.N.(A)). McGiU. 

This study is concerned with the problem of 
whether students tend to conform to the 
pattern of nursing care that they see practiced 
in the setting where they are learning to nurse. 
The hypothesis tested was that there is a rela- 
tionship between the type and amount of in- 
formation about the patient as a person as 



recorded on the nursing care plan and the type 
and amount of information recorded by the 
nursing student about the same patient. 

A content analysis of the written nursing 
caie plans for 10 nursing units in one hospital 
revealed that the information about the person 
could be placed in three categories: social- 
cultural, medical history and continuity of care, 
and emotional supportive. A form was designed 
on which this type of information could be 
recorded. Fifty-eight first-year students from 
10 hospital nursing units in one hospital partici- 
pated in the study. Data were collected from 
the nursing care plans of 104 patients assigned 
to these students. After caring for the patients 
during one day, the students recorded in- 
formation about the same 104 patients. The 
amount of information written by the student 
was then compared with the amount of in- 
formation from the nursing care plans. 

The data were analyzed first by computing 
correlation coefficients for each category of in- 
formation and for the total amount of informa- 
tion. A positive relationship at the .01 level of 
significance was found. In the 10 nursing units 
the information from the students was ranked 
on the basis of the mean scores, and Spearman 
rho correlation coefficients were calculated. A 
positive significant relationship was found in all 
categories with the exception of the social- 
cultural category. 

These findings tend to support the hy- 
pothesis as stated. Q 



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THE CANADIAN SLRSE 47 



Now available 

THE SECOND EDITION OF 

COUNTDOWN 

CNA'S YEARBOOK OF CANADIAN NURSING STATISTICS 



One-third larger than last year's edition, COUNT- 
DOWN 1968 contains commentary and 133 sta- 
tistical tables updated to present the latest 
available data on nursing manpower, education, and 
salaries. 

An exciting addition this year is the inclusion of 
salaries paid to nurses employed in public general 
hospitals throughout Canada. 

A cross-reference between COUNTDOWN and 
FACTS ABOUT NURSING, published by the 
ANA, is available from CNA. 

Act now. Continue your collection of COUNT- 
DOWN with the 1968 edition by clipping and 
mailing the coupon below. 



TO: Canadian Nurses' Association 
50 The Driveway 
Ottawa 4, Ontario 



Please send 

per copy, to: 

Name 



(no. of copies) of Countdown 1968, at $4.50 



Address 


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Enclosed 


48 THE CANADIAN NURSE 








JANUARY 1969< 



Individuality in Pain and Suffering by 

Asenath Petrie, B.Sc, Ph.D. 153 pages. 
Chicago, The University of Chicago 
Press, 1967. Canadian agent: University 
of Toronto Press, Toronto. 
Reviewed by Myrtle A. Kutschke, Assis- 
tant Professor, School of Nursing, Mc- 
Master University, Hamilton, Ont. 

In this book, the author includes her 
own previously published work, that of 
others, and her current research. 

The writing style is clear. The research 
method is described briefly in the text and 
in detail in the appendices. Although a 
rudimentary knowledge of statistics would 
allow the reader to understand the detail of 
the findings, clear interpretations are in- 
cluded. 

In respect to research method, variables 
seem to be controlled statisfactorily. How- 
ever the reader may have some quarrel 
with the small numbers in several samples. 
Also, "normal" subjects tend to represent 
groups readily available, such as student 
nurses. Some work was done to ensure that 
student nurses were not a bias sample. Ran- 
dom sampling is not evident. 

Her research concerns individual varia- 
tion in pain tolerance and sensory depriva- 
tion. "The results of the study . . . suggest a 
neurological or physiological basis for this 
variation. . . ." Using a simple kinesthetic 
test, individuals are placed in one of three 
categories in relation to their reception of 
stimuli. The three categories are augmenter, 
reducer, and moderate. As the words indi- 
cate, the augmenter tends to enlarge stimuli 
received, the reducer tends to decrease stim- 
uli, and the moderate leaves the stimuli 
unchanged. 

Findings indicate that patients tolerating 
pain poorly are augmenters, while those 
tolerating pain well are reducers. The re- 
verse is true for sensory lack or isolaticm. 
The author explains that the augmenter per- 
ceives pain more fully and therefore has 
more sensation to tolerate. The reducer on 
the other hand has minimal sensation to 
endure. Because the reducer makes poor use 
of sensation, however, he feels the discom- 
fort of isolation or sensory deprivation more 
intensely than does the augmenter. 

Juvenile delinquents, alcoholics, and schiz- 
ophrenics were among the groups tested. 
Each group showed a characteristic pattern. 
For example, there is a higher percentage 
of reducers among juvenile delinquents than 
among the control group. The author sug- 
JANUARY 1%9 



gests that some of the destructive behavior 
of juvenile delinquents may be methods of 
increasing stimuli to overcome feelings of 
sensory deprivation. She states that these 
findings may be useful in planning programs 
of rehabilitation and prevention. 

The effect of drugs on the relief of pain 
differs between the augmenter and the re- 
ducer. These findings are important to the 
nurse in anticipating results of administra- 
tion of analgesics. If persons do vary neu- 
rologically or physiologically in their toler- 
ance of pain and sensory lack, this data 
must be included in the problem-solving pro- 
cess of planning individualized nursing care. 
For example, an augmenter in a busy in- 
tensive care unit may find the bombardment 
of stimuli intolerable, while a reducer in a 
single room may find the relative lack of 
stimuli stressful. 

This book is a good basis for clinical 
nursing studies. 

Nurse researchers could design experi- 
mental studies to develop nursing interven- 
tions that would compensate for a patient's 
tendency to augment or reduce. 

Communication for Nurses, 3rd ed., by 
Florence K. Lockerby, A.B., M.A. 120 
pages. St. Louis, Mosby, 1968. 

The third edition of this book proposes 
to tell the nurse how to communicate with 
her patients, her fellow workers, and the 
general public. Unfortunately, it has some 
difficulty in communicating with its readers. 

Unlike the previous two editions, this one 
is directed not at student nurses but at nurses 
in general. With this more mature and 
knowledgeable audience in mind, the author 
is less chatty and uses more impersonal 
constructions and jargon. 

The content as well as the style has been 
changed. Whereas half of the second edition 
is devoted to an explanation of communica- 
tion in everyday life, only the first 27 pages 
of the third edition discuss communication 
in general. The rest of the book concerns 
communication for nurses. 

Two changes in this edition could be 
considered improvements. This edition is 
more meticulously organized. Each chapter 
begins with a numbered outline of the chap- 
ter's contents and ends with a series of de- 
tailed questions on how to apply information 
contained in the chapter. More real-life ex- 
amples in the form of anecdotal accounts of 
clinical experiences are used. 

However, the author has become immers- 



ed in the complexities of language and rare- 
ly surfaces to enlighten the reader. For ex- 
ample: "In such situations, the following 
factors confound the participants' symboliz- 
ation and mutual perception: 

1. Peripheral involvement of other people 

2. Emotional symbolization of incident 

3. Disruptive lapse of time." 

Such factors confound the reader as well. 

The final chapter of the third edition is 
substantially the same as the final two 
chapters of the second edition. This section 
is specifically directed to the student nurse. 
It contains useful examples of how the stu- 
dent can establish rapport with her patients 
and help to create a favorable image for 
her hospital. It explains the value of active 
participation in nursing organizations, con- 
ferences, and workshops. How to deliver a 
public speech is outlined and notes on how 
to write for publication are given. 

For the person interested in developing 
his writing ability, the annotated bibliogra- 
phy alone — which has been enlarged in this 
edition — makes this book worthwhile. 
Most of the books listed are directed prim- 
arily at writers. 

Workbook For Community Health 
Nursing Practice compiled by Commun- 
ity Health Nursing Faculty, University 
of Washington School of Nursing. Palo 
Alto. California, Pacific Books, 1968. 
Reviewed by Phyllis E. Jones, Assistant 
Professor, University of Toronto. 

This book contains the material required 
during the community nursing experience of 
students in the school of nursing at the Uni- 
versity of Washington. It is intended "to 
guide the student in the application of com- 
munity health nursing prniciples and skills 
as a family and community health worker 
in the home, clinic, school and community." 

It is a student workbook, designed to fit 
a three-ring binder and composed of remov- 
able perforated pages. The contents include 
a variety of guides: for observation of home 
visit, community analysis, family analysis, 
process recording, and self-evaluation. A 
listing of assignments required of students 
during this practice period is included. State- 
ment of policies regarding student work 
should be helpful to students and agencies 
alike; these relate to such things as time in 
the agency, health, uniform, and transporta- 
tion. 

This book will be of greatest use in the 

educational setting for which it was design- 

THE CANADIAN NURSE 49 




ed. The statements of philosophy and ob- 
jectives are brief and how to use the book 
is not explained. Therefore, this book could 
not be transferred without modification to 
other settings. It does, however, serve as an 
example of an attractive and effective meth- 
od of organizing aids to learning developed 
for a specific setting. It will particularly 
interest educators who deal with similar 
questions of organizing teaching aids. 

Simplified Nursing, 8th ed. by Claire P. 
Hoffman, R.N., M.A., Gladys B. Lipkin, 
R.N., B.S., Ella M. Thompson, R.N., B.S. 
692 pages. Toronto, J.B, Lippincott, 1968. 
Reviewed by Leota Daniels, Instructor, 
Payzant Memorial Hospital, Windsor. 

This text presents a comprehensive view 
of the fundamentals of nursing. A realistic 
approach to the human side of nursing is 
stressed. Although procedures are simplified, 
the principles of good nursing care are 
adeptly presented. 

The first unit describes the community in- 
volvement required of the modem nurse. 
TTie importance of personality, interperson- 
al relations, spiritual factors, and legal as- 
pects of nursing care to both practical and 
professional nurses is stressed. 

The second unit acquaints the student 
with her role in relation to the family as 
well as the patient. Unit 3 deals with the 
functions of the human body. Colored dia- 
grams are labelled in simple terms bringing 
the information to the level of every stu- 
dent. Glandular and organic function and 
body structures are well outlined. 

The simplified approach to nursing is ap- 
plied in succeeding units to topics such as 
nutrition, special diets, rehabilitation, nurs- 
ing arts. Many of the more involved med- 
ical procedures such as hemodialysis, the 
cardiac pacemaker, and fetal monitoring are 
outlined in principle to help the student 
understand these involved medical tech- 
niques. 

Unit six deals with the therapeutic ap- 
proach to various disorders and abnormal- 
ities such as orthopedic, psychiatric, and 
cardiovascular diseases. A patient-centered 
approach involving individual needs is stres- 
sed. 

The concluding unit concerns maternal 
and child care. The appendix includes a 
brief but comprehensive classification of 
therapeutic agents. Guidelines are given to 
the skilled observation of the effects of 
many widely used medications. A glossary 
of medical terms is also included. 

This text is a comprehensive approach to 
nursing fundamentals. It can be easily under- 
stood by the student of practical nursing. 
50 THE CANADIAN NURSE 



This edition will also be helpful to the in- 
active nurse who wishes to return to the 
profession. 

Adolescent Psychiatry, edited by S.J. 
Shamsie, M.D. 84 pages. Pointe Claire, Que., 
Schering Corporation Limited, 1968. 

This book contains the complete proceed- 
ings of the first conference on adolescent 
psychiatry held in Canada at the Douglas 
Hospital, Montreal, in June 1967. 

Commenting on the publication, the editor. 
Dr. Shamsie said: "In this one volume we have 
attempted to trace the development and treat- 
ment of adolescent problems, with particular 
emphasis on Canadian experience." 

Subjects covered include: "The Varieties of 
Adolescents' Behavioral Problems and Family 
Dynamics" by Dr. R.L. Jenkins, professor of 
child psychiatry at the University of Iowa, and 
"Biological Growth during Adolescence" by Dr. 
J. Robertson Unwin, director of adolescent 
services at the Allan Memorial Institute in 
Montreal. 

Dr. Henry Kravitz, psychiatrist in chief at 
the Montreal Jewish Hospital discusses the 
"Management of Adolescents in the General 
Hospital Setting." Dr. Jean L. LaPointe, super- 
intendent of the Mont Providence Hospital 
writes about "Educational Problems in 
Disturbed Adolescents." 

The "Adolescent in the Family," the 
"Adolescent in Juvenile Court," and 
"Adolescence as Rebirth" are covered respec- 
tively by Dr. Ronald B. Feldman, director of 
family and child psychiatry at the Jewish Gen- 
eral Hospital, Dr. S.J. Shamsie, chief of 
adolescent services at Douglas Hospital, and 
assistant professor of psychiatry at McGill Uni- 
versity, and Dr. Vivian Rakoff, director of 
psychiatry research at the Jewish General. 

Clinical Nursing Workbook for Practi- 
cal Nurses, 3rd ed., by Marilyn Gottehrer 
Freedman. M.A., R.N., and Justine Hannan, 
M.A., R.N. 207 pages. Philadelphia, F.A. 
Davis, 1968. Canadian agent: Ryerson, 
Toronto. 

Reviewed by Donna Dineen, Charge Nurse. 
A uxiliary Staff, St. Mary 's General Hospital, 
Kitchener, Ont. 

This manual is an up-to-date workbook for 
the education of the student practical nurse. 

It is divided into three sections. The first 
unit on medical and surgical nursing reviews 
body structure and function, and common 
systemic disorders, including the nursing care 
and pertinent drugs used in the treatment of 
these common medical-surgical conditions. 

The second section, maternal and child 
health, deals with the pre and postpartum pa- 
tient, nursing care of the newborn, and care of 
the sick child. Its major objectives are to 
protect the health of the mother and child and 
to lower the mortality rate. It points out how 
the practical nurse can best help her patients to 
attain these goals through her knowledge, skills, 
and attitudes. 

The third section concerns the care of the 



mentally ill. It covers psychopathology, 
psychosis, and personality disorders with their 
appropriate nursing care, including shock and 
chemotherapy. 

This book covers the entire practical nurses' 
course well. Its presentation is concise and com- 
plete. Although the psychiatry chapter and 
medications cover more than is actually 
necessary for the nine-month course, it proves 
to be interesting additional learning. The biblio- 
graphies are extensive, and therefore useful for 
extra assignments. Each new topic is preceded 
by an anatomical diagram; however, at times 
they appear jumbled and are too small to 
clarify needed details. 

This manual would be of much assistance to 
the instruction of practical nurses. 

ANA Regional Clinical Conferences, 

American Nurses' Association, 1967. Phi- 
ladelphia/Kansas City. 322 pages. New 
York, Appleton-Century -Crofts, 1968. 
Reviewed by Frances Pishker, Lecturer, 
School of Nursing, Queen's University, 
Kingston, Ont. 

This book is a compilation of papers 
presented at American Nurses' Association 
Regional CUnical Conferences in 1967. 

Fourteen papers presented at general 
sessions are concerned with three major issues: 
the nurse's involvement in health planning from 
national to local levels in the health care system 
in the United States; the use of computers in 
hospital; and discovery, dissemination, and 
utilization of the expanding body of nursing 
knowledge. Thirty papers presented at clinical 
sessions are evenly divided among the following 
areas of nursing practice: community health, 
geriatrics, maternal and child health, medical- 
surgical, and mental health and psychiatric 
nursing. Two papers presented at general 
clinical sessions are concerned with new 
methods of continuing education for graduate 
nurses: teaching new, highly speciaUzed care 
techniques, and the use of communications 
media in inservice education programs. 

The clinical sessions are particularly interest- 
ing. Nurse cUnicians, teachers, and researchers 
discuss new approaches to nursing care in 
papers based on experimental studies, pilot 
projects, and case presentations. Some papers 
are primarily considerations of theory, and a 
few are refreshingly controversial. The section 
on geriatric nursing is well worth special 
attention for the dynamic and vital approach it 
brings to health care problems of aged people. 
Nancy llio's discussion of health care in an 
urban ghetto is a high point in the community 
health nursing section. The psychiatric and 
mental health nursing sessions include a number 
of exceptional papers. 

The papers are six to eight pages in length, 
clearly presented, and easily read. Advantages 
of brevity are occasionally out-weighed by 
superficial treatment, but this may be a carping 
criticism in view of the overall merits of the 
publication. One can hardly expect such a large 
number of papers to be of uniform quality. 

This volume has a lot to offer nurses 

engaged in direct patient care. It should be a 

JANUARY 1969 




useful addition to nursing libraries and to the 
personal collections of nurses who either do not 
have access to a variety of periodicals or cannot 
find time to read them. Good references are 
provided with each paper, and the nursing 
teacher and student will find this book 
profitable when used in conjunction with 
source material. 

How to Pass Entrance Examinations for 
Registered and Graduate Nursing 
Schools compiled by editors of Cowles 
Education Corp. 399 pages. Toronto. W.B. 
Saunders, 1968. 

Reviewed by Dr. M. Josephine Flaherty, 
Lecturer, Department of Adult Education. 
The Ontario Institute for Studies in 
Education. Toronto. 

This book is written for nursing school 
candidates. It purports to prepare such can- 
didates for all the variations of academic and 
nursing tests used in current nursing entrance 
e.xaminations. The latter include pre-entrance 
tests (for candidates seeking admission to basic 
nursing programs), which are thought to 
measure a candidate's aptitude for nursing as 
well as his general scholastic aptitude, and 
nursing achievement tests, which are written by 



graduate nurses seeking admission to university 
schools of nursing. 

The book provides general information and 
advice about applying for admission to nursing 
school examinations in the United States, and 
instructions regarding how to take and score 
sample tests in the book. Sample tests include 
verbal, numerical, mathematical, reading com- 
prehension, science, general information, and 
social studies tests for prenursing candidates, 
and medical-surgical nursing, maternal and child 
nursing, psychiatric nursing, and science in 
nursing tests for the graduate nurse students. 
With each group of tests, a short note on the 
nature of the tests and a set of "do's and 
don'ts" for dealing with the tests are given. 

Without a set of well-defined objectives, it is 
impossible to evaluate the validity of any test 
or group of tests; hence no attempt has been 
made to do so in this review. It is probably 
more appropriate to look at the purpose for 
which the book was written and to attempt to 
assess its usefulness on the Canadian nursing 
scene. 

If the purpose of an aptitude test is to help 
to estimate the future success of an individual 
in a particular occupation or educational pro- 
gram, it seems reasonable to sample certain 
psychological characteristics and acquired skills 
that are believed to be requisite to success in 
the specified occupation or educational pro- 
gram. Such measurement should be uncon- 
taminated by specific preparation or practice 
by the candidate for the aptitude test itself. 



This "how to pass" text is intended to give 
students some practice in test-taking: this in 
itself is probably not a bad idea, as it may help 
to dispel students' fears about the format and 
conduct of the test situation. However, the 
book also suggests that candidates study the 
correct answers carefully, score themselves, 
determine their area of weakness, and "plan a 
program of intensive study to insure success on 
the professional nursing school admission 
tests." This sort of procedure appears to lose 
sight of aptitude measurement, and to em- 
phasize the content of the pre-entrance ex- 
amination. Surely the aim of the schools should 
be to select candidates who really possess the 
characteristics and skills considered necessary 
for success in nursing rather than those can- 
didates who are able to find out what is likely 
to be on the aptitude examination and learn the 
correct responses, without necessarily under- 
standing why those responses are correct. 

Similarly, with graduate nurse examinations, 
the objective is to assess the abilities and skills 
required by a candidate during her basic edu- 
cational program in nursing and during her 
work experience in the profession. Attempts to 
practice or prepare specifically for the tests 
would tend to defeat the purpose of the ex- 
amination program. Hence, one should question 
whether a "how to pass" book such as this one 
has any merit. 

Although the sections on "do's and don'ts" 
of test-taking might be helpful to students who 
arc unaccustomed to writing obiective ex- 



THE 
FULLER 
SHIELD: 




Keeps dressings firmly in place 
Prevents soiling of clothing, bed linen 

The ideal post-operative dressing for patient 
comfort, nursing convenience. The FULLER 
SHIELD, designed on undergarment lines, is a 
protective dressing especially made to maintain 
anal, perianal or sacral dressings comfortably 
in place v\^ithout binding, without use of tapes. 

Surgeons order two FULLER SHIELDS 
for each patient. (One on and one off.) 
Nurses are glad they do. 

Request samples through your hospital 
purchasing agent. 



w' 



WINLEY-MORRIS lTd 




JANUARY 1%9 



THE CANADIAN NURSE 51 




aminations, the purpose and hence the content 
of the rest of the book seem to have little to 
recommend it for use by nursing school can- 
didates. This book is not recommended for 
inclusion in nursing school libraries. 



Biology of Human Behavior by Eleanor 
Page Bowen. R.N,, Ed.M. 607 pages. New 
York, Appleton-Century-Crofts, 1968. 
Reviewed by Margaret N. Lee, Associate 
Professor, School of Nursing, Laurentian 
University, Sudbury, Ontario. 

In her preface to Biology of Human 
Behavior the author points out that the book is 
designed as a textbook for schools of nursing 
that offer one integrated science course. 

The contents are divided into units and sub- 
divided into chapters. These describe the anato- 
mical and physiological functioning of the 
various systems of the human body and discuss 
the consequences of impairment to these 
systems. Each chapter ends with a discussion of 
the nursing implications of the contents of the 
chapter. 

The illustrations are in black and white, 
although colored illustrations would probably 
have been more useful for students. 

This book is written at a level that may 
make it useful to beginning students whose 
background of high school science is limited, 
and who have chosen to follow a nursing 
curriculum that includes only one integrated 
science course. It would be less useful to 
students in a baccalaureate degree program in 
nursing. 



A Programmed Introduction to Micro- 
biology by Stewart M. Brooks, M.S. 100 
pages. Saint Louis, Mosby, 1968. 
Reviewed by H. Kernen, M.A., R.T., 
Director, Medical Laboratory Technology 
Program, Saskatchewan Institute of Applied 
Arts & Sciences, Saskatoon. 

Programmed texts are often most useful 
when integrated with a standard text used as a" 
basis for a course of lectures. This text seems 
particularly well integrated with Textbook of 
Microbiology by Kenneth L. Burdon and R. P. 
Williams, 6th edition. 

This book is divided into three parts: Fun- 
damentals of Microbiology, Practical Aspects of 
Microbiology, and Microorganisms and Disease. 

There are 21 diagrams. The program is 
linear, the template easy to operate, and it is 
less tedious than many linear programs. 

Not all students like or profit from pro- 
grammed texts and certainly not all students 
approach programmed texts in the same state 
of mind or use them in the same manner. To 
my surprise a group of nursing students in the 
Saskatchewan Institute of Applied Arts and 
Sciences, who were having difficulties earlier 
52 THE CANADIAN NURSE 



this year in learning microbiology, used this 
text in a novel manner with good results: they 
studied together as a group looking at one book 
and discussing aloud the possible answers to 
each frame. 



Resuscitation : A Programmed Course 

by Leonard P. Caccamo, M.D., Edward 
Kessler, M.D. and J. Leonard Azneer, Ph.D. 
113 pages. Toronto, The Ryerson Press, 
1968. 

Reviewed by Jean-Paul Dechine, M.D., 
Chief, Anesthesia-Resuscitation Depart- 
ment, Laval Hospital, Quebec City. 

This book, presented in the form of a ques- 
tionnaire, reviews each phase of cardio- 
pulmonary resuscitation, thus enabling the 
reader to evaluate his knowledge. 

Each principle is very well explained and 
completed by illustrations. 

Blank space has been left for personal ob- 
servations. 

This book should be used as a basic text- 
book as well as a reference book by all para- 
medical personnel involved in cardio-pulmonary 
resuscitation. 



The Lung And Its Disorders In The New- 
born Infant, 2d ed., by Mary Ellen 
Avery, A.B., M.D., 285 pages. Toronto, 
W.B.Saunders, 1968. 

Reviewed by Shirley E. Pitt, R.N., P.H.N., 
Nursing Coordinator, Home Care 
Department, The Children's Hospital of 
Winnipeg, Winnipeg. 

This second edition, written primarily for 
medical clinicians and investigators, is an 
excellent reference book for all professional 
personnel who are working with the newborn 
infant. It is especially valuable for nurses 
who work in maternity nurseries or newborn 
intensive care units. 

This up-to-date, detailed text is divided 
into three parts. 

The first section discusses normal deve- 
lopment and physiology of the fetal and 
newborn lung. Subheadings cover the topics 
of intrauterine respiration in the fetal lung, 
the aeration of the lung at birth, perinatal 
circulation, the regulation of respiration, 
methods of study of pulmonary function in 
infants, and roentgenographic evaluation of 
the chest. 

Part II outlines the disorders of respira- 
tion in the newborn period, including con- 
genital anomalies, infections, aspiration 
syndromes, and persistent pulmonary dys- 
function in premature infants. This section 
has an informative chapter on hyaline 
membrane disease and other conditions 
associated with hyaline membranes. 

In the last section, the doctor talks about 
artificial respiration. Topics discussed inclu- 
ded recuscitation at birth, infants at special 
risk at birth, evaluation of the newborn 
(APGAR rating), and criteria for recuscita- 
tion and the techniques of recuscitation. 



Dr. Avery states that the intent of the 
clinical summary in the text is to stress that 
there are many causes of respiratory distress 
in the newborn period; she goes on to say 
that the most likely diagnosis can be suspec- 
ted from the history and by inpection of the 
infant. The most helpful diagnostic aid is the 
chest film. 




Two New Catalogs 

A new Handbook of Educational Material 
for Guidance, Health, and Sex Education has 
been prepared for schools. The 16-page catalog 
lists filmstrips, slides, films (16mm), and film 
loops (Super 8 or Standard 8). The audiovisual 
materials are available for purchase to aid in 
instruction or guidance, health, and family life 
education for teenage audiences. 

Nursing educators may wish to be familiar 
with these aids as high school students entering 
nursing will likely have seen some of these 
materials. Public health nurses will be interested 
in knowing of new audiovisual aids for use in 
schools. Some of the materials may be suitable 
as aids in anatomy and physiology lectures in 
diploma programs. 

Requests for the catalog should be sent to 
Mclntyre Educational Materials Ltd., at 3333 
Metropolitan Blvd. East, Montreal 455, P.Q. or 
at 123 Eglinton Ave. East, Toronto 12. 

Davis and Geek has released a November 
1968 supplement to its Surgical Film Catalog. 
The catalog lists new additions to the Davis and 
Geek Surgical Film Library. 

One of the new films, cntitled"Sychronous 
Combined Resection of the Rectum," was 
filmed in Canada at two Toronto hospitals. It 
describes details of a two-team abdomino- 
perineal resection for carcinoma of the rectum. 

Davis and Geek Surgical Film Library loans 
medical and nursing films to Canadian hospitals 
and educational facilities; the library has some 
250 subjects with approximately 1,300 prints 
available. Further information about the films 
may be obtained by writing to Davis and Geek 
Film Library, c/o P.O. Box 1039, Montreal 3, 
Quebec. D 



accession list 



Publications on this list have been received 
recently in the CNA library and are listed in 
language of source. 

Material on this list, except Reference items, 
including theses, and archive books that do not 
circulate, may be borrowed by CNA members, 
schools of nursing and other institutions. 

Requests for loans should be made on the 

"Request Form for Accession List" and should 

be addressed to: The Library, Canadian Nurses' 

Association, 50 The Driveway, Ottawa 4, 

JANUARY 1969 



accession list 



No more than three titles should be re- 
quested at any one time. 



BOOKS AND DOCUMENTS 

1. Analyzing and reducing employee turn- 
over in hospitals. New York, United Hospital 
Fund of New York, Training Research and 
Special Studies Division, 1968. 94p. 

2. An approach to the teaching of psy- 
chiatric nursing in diploma and associate degree 
programs: a method for content integration and 
course development in the curriculum by Joan 
E. Walsh and Cecilia Monat Taylor. New York, 
National League for Nursing, 1968. 78p. 

3. L'avortement par Serge Mongeau et 
Renee Cloutier. Montreal, Editions du Jour, 
1968. 173p. 

4. The challenge of changing patterns; re- 
port of the first conference of National League 
for Nursing Western Region Committee on 
Community Nursing Service. San Mateo, Calif, 
Mar. 22-23, 1968. San Francisco, 1968. 46p. 

5. Clinic nursing: explorations in role inno- 
vation by Herman Turk and Thelma Ingles. Phi- 
ladelphia, F.A. Davis Co., 1963. 192p. 

6. Cooper's nutrition in health and disease 
by Helen S. Mitchell et al. 15th ed. Philadel- 



phia, Lippincott, cl968. 685p. 

7. Emerging sectors of collective bargaining. 
Montreal, McGiU University. Industrial Rela- 
tions Centre, 1968. 120p. 

8. Etudes sur le parler frangais au Canada. 
Prepare par La Societe du Parler fran^ais au 
Canada. Quebec, Les Presses Universitaires 
Uval, 1955. 220p. 

9. Fate, hope and editorials; contemporary 
accounts and opinions in the newspapers 
1862-1873, microfilmed by the CLA/ACB 
microfilm project by Helen Elliot. Ottawa, Can- 
adian Library Association, 1967. 190p. 

10. The graduate education of physicians 
by the Citizens Commission on Graduate 
Medical Education. Report commissioned by 
the American Medical Association. Chicago, 
American Medical Association, 1966. 114p. 

11. Guidelines for discftarge planning by 
Janis H. David, Johanne E. Hanser and Barbara 
W. Madden. Downey, Calif., Attending Staff 
Association of Rancho Los Amigos Hospital, 
C1968. 52p. 

12. Health care needs; basis for change. 
Papers of the first regional conferences. New 
York, National League for Nursing. Council of 
Hospital and Related Institutional Nursing Serv- 
ices, 1968. 63p. 

13. History of nursing by Josephine A. 
Dolan. 12th ed. Philadelphia, Saunders, 1968. 
380p. 

14. Hospital safety and sanitation with spe- 
cial reference to patient safety. Michigan, Uni- 



versity of Michigan, School of Public Health, 
C1962. 208p. 

15. The Merck Index; an encyclopedia of 
chemicals and drugs. 8th ed. Rahway, N.J., 
Merck & Co., 1968. 171 3p. R 

16. Pharmacology and drug therapy in 
nursing by Morton J. Rodman and Dorothy W. 
Smith. Philadelphia, Lippincott, cl968. 738p. 

17. The photography of H. Armstrong Ro- 
berts. Philadelphia, 1968. 96p. 

18. The physician by Russel Lee, Sarel 
Eimerl and the editors of Life. New York, Time 
Inc., cl967. 200p. 

19. A practical style guide for authors and 
editors by Margaret Nicholson. 1st ed. New 
York, Holt, Rinehart and Winston, cl967. 
143p. 

20. Professionalism and salaried worker or- 
ganization by Archie Kleingartner. Milwaukee, 
Wisconsin, Industrial Relations Research Insti- 
tute, University of Wisconsin, 1967. 113p. 

21. Psychiatric nursing in general hospitals. 
Proceedings of the Canadian Conference on 
Nursing in Psychiatric Divisions of General 
Hospitals, First, Montreal. November 1958. 
Montreal, McGill University, 1958. 84p. 

22. Questions and answers about contact 
lenses by Barnes-Hind Pharmaceuticals, Inc. 
New York, DeU, 1968. 64p. 

23. Report of the Nursing Seminar, Tehe- 
ran, Iran, 9-19 November 1966. Alexandria, 
World Health Organization, Regional Office for 
the Eastern Mediterranean, 1968. 50p. 

24. Report of the Ontario Cancer Treat- 




CHASE 
HOSPITAL 
DOLLS 

For demonstrating and practicing the 
newest nursing techniques • lavage and 
gavage • tracheotomy and colostomy, 
and their post-operation care • nasal 
and otic irrigations • catheterization and 
all abdominal irrigations * subcutane- 
ous, intramuscular and intradermal injec- 
tions • and all standard nursing procedures. 
Let us tell you about the new features we 
have added to this world-famous teaching 
aid. Write to 

M. J. CHASE Co. Inc. — 156 Broadway 
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JANUARY 1%9 



THE CANADIAN NURSE 53 



accession list 



ment and Research Foundation, 1965/67. Tor- 
onto, 1968. 209p. 

25. Reports to the general annual meeting, 
44th. Toronto, Ontario Hospital Association, 
1968. 66p. 

26. Risume du rapport (par G.M. Weir) de 
I'enquete au sujet de la formation des gardes- 
malades au Canada. Prepare par le docteur 
Alfred T.- Bazin. Traduit par le docteur J. -A. 
Baudouin. Montreal, Autorise par le Comite de 
Regie de I'Association des Gardes-Malades Enre- 
gistrees de la Province de Quebec, 1932. 
136p. R 

27. Survey methods applied to schools of 
nursing and hospital nursing services. Pro- 
ceeding of short course held at Indiana Uni- 
versity, July 38-August 9, 1947. Bloomington, 
Indiana. Indiana University, Division of Nursing 
Education, 1948. 21 Op. 

28. Team nursing; a programmed learning 
experience by Russell C. Swansburg. New York, 
Putnam's, cl966, 1968. 4v. 

29. The writer's handbook. Edited by A.S. 
Burnack. Boston, The Writer, Inc., cl968. 
765p. 

PAMPHLETS 

30. Basic cataloguing tools for use in Can- 
adian libraries; a report to the CLA technical 



services section. Rev. ed. by Beryl L. Anderson, 
Ottawa, Canadian Library Association, 1968. 
28p. 

31. Basic guidelines on press relations for 
management. Toronto, Public & Industrial 
Relations Ltd., 1968. 13p. 

3 2. Catalogue of films on world de- 
velopment. Ottawa, Canadian Council for Inter- 
national Development, 1968. 32p. 

33. Code for nurses with interpretive state- 
ments. New York, American Nurses' As- 
sociation, 1968. 12p. 

34. Check and double check in education 
by Fred E. Whitworth. Ottawa, Canadian 
Council for Research in Education, 1967. lOp. 

35. Education for nursing the diploma way. 
New York, National League for Nursing. De- 
partment of Diploma Programs, 1968. 40p. 

36. Graduate training for family practice. 
Kansas City, American Academy of General 
Practice. Commission on Education, 1967. 24p. 

37. Handbook for nurses on leprosy by 
Eileen Greenwood. Vellore, India, 1967. 27p. 

38. A manual on training in family medi- 
cine. Don Mills, Ont., The College of I-amily 
Physicians of Canada. Committee on Advanced 
Training, 1967. 25p. 

39. Nurses' guide to Canadian drug legisla- 
tion by David R. Kennedy. Toronto, Lippin- 
cott, 1968. lip. 

40. Project for the preparation of teachers 
for associate degree programs in nursing. 
College of Nursing. University of Florida. Vol. 
5, fifth and final report to the W.K. Kellogg 



Foundation, Jan-Dec. 1964. Gainesville, Fla., 
1964. 39p. 

41. R e-employment factors of inactive 
nurses in Wisconsin. Prepared by the Wisconsin 
Nurses' Association, Inc. Milwaukee, Wisconsin, 
1968. 42p. 

GOVERNMENT DOCUMENTS 

Canada 

42. Bureau du Conseil Prive. Secretariat des 
Sciences. La psychologic au Canada par M.H. 
Appley et Jean Rickwood. Ottawa, 1967. I45p. 

43. . La statistique de I'etat civil, 

1966. Ottawa, Imprimeur de la Reine, 1968. 
213p. 

44. Bureau of Statistics. List of hospital in- 
dicators, 1966. Ottawa, Queen's Printer, 1967. 
17p. 

45. . Survey of higher education: 

part 1: fall enrolment in universities and 
colleges. Ottawa, Queen's Printer, 1968. 61p. 

46. Conseil Economique du Canada: Difi 
pose par la croissance et le changement. 
Ottawa, Imprimeur de la Reine, 1968. 235p. 

47. Dept. of Manpower and Immigration. 
Career decisions of Canadian youth; a com- 
pilation of basic data, vol. 1, 1967, by 
Raymond Breton and John C. McDonald. 
Ottawa, Queen's Printer, 1967. 203p. 

48. . University, college and tech- 
nological; guide; graduations, enrolments, 
salaries. Prepared by . . . the Professional and 
Technical Occupations Section, Manpower In- 
formation and Analysis Branch, Program De- 



Request Form for "Accession List" 
CANADIAN NURSES' ASSOCIATION LIBRARY 

Send this coupon or facsimile to: 

LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. 

Please lend me the following publications, listed in the 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

Short title (for identification) 



issue of The 



Item 
No. 



Author 



Requests for loans will be filled in order of receipt. 

Reference and restricted material must be used in the CNA library. 

Borrower Registration No. 

Position 



Address 

Date of request 



54 THE CANADIAN NURSE 



JANUARY 1969 



accession list 



velopment Service. Ottawa, 1968. 45p. 

49. Dcpt. of National Health and Welfare. 
Earnings of physicians in Canada. J 966. 
Ottawa, 1968. 33p. 

50. . Report. 1967. Ottawa, 

Queen's Printer, 1968. 261p. 

51. National Library of Canada. Canadian 
theses 1965/66. Ottawa, Queen's Printer, 1968 
195p. 
Ontario 

5 2. Department of Labour. Research 
Branch. Wages, hours and overtime pay pro- 
visions in selected industries. Ontario, 196 7. 
Toronto, 1968. 25p. 
Quebec 

53. Ministere de la Sante. Les services 
sociaux scolaires. Quebec, Service de I'lnforma- 
tion des ministeres de la Sante, de la Famille et 
du Bien-ttre social, 1968. 146p. 

54. Ministere de la Sante. Trois 
experiences-pilotes du gouvernement du Que- 
bec: retour a la vie normale par . . , et les minis- 
teres de la Famille et du Bien-etre social du 
Quebec. Quebec, 1968. 36p. 
Saskatchewan 

55. Department of Education. Evaluation 
of the state of nursing education in Saskat- 
chewan. July 1. 1967 ~ June 30, 1968. Regina 
1968. 13p. 

U.S. A. 



56. National Archives and Records Service. 
Office of the Federal Register. U.S. government 
organization manual, Washington, U.S. Gov't 
Print. Off. 842p. 

57. National Center for Health Statistics. 
Employment during pregnancy. Washington, 
Public Health Service, 1968. 30p. 

^8- • Nursing and personal care serv- 
ices: received by residents of nursing and per- 
sonal care homes. United States, Mav-June. 

1964. Washington, Public Health Service 1968 
41p. 

STUDIES DEPOSITED IN 

CNA REPOSITORY COLLECTION 

5 9. Canadian graduate nurse students 
studying for master's and doctoral degrees in 
National League for Nursing accredited pro- 
grams in colleges and universities in the United 
States of America, June 1968 by Shirley R. 
Good. Ottawa, Canadian Nurses' Association 
1968, 63p. R 

60. The cottage hospital and the R.N.: some 
aspects of and demand on the cottage hospital, 

1965. St. John's, Newfoundland, Dept, of 
Health, 1965. 26p. R 

61. Evaluation of the activities of nursing 
unit personnel, 1959-1965 by Nursing Con- 
sultants, Hospital Operating Standards Division 
in cooperation with the Statistical Research 
Division. Toronto, Ontario, Hospital Services 
Commission, 1968. 266p. R 

62. A study of the relationship between the 
information about the patient as a person 



which is recorded on the nursing care plan and 
the information about the same person as 
recorded by the student after nursing the 
patient by Florence I. Mackenzie. Montreal, 
1968. 39p. Thesis (M.Sc.N.(App.)) - McGill.R 
63. A study to determine the influence of 
selected factors in choosing a head nurse's 
position by Yolande Proul.x. Boston, 1968. 
78p. Thesis (M.Sc.N.) - Boston. R 

64. A study to explore the relationship be- 
tween absence events and the scheduling of 
time and work assignments of registered nurses 
and nursing assistants in selected units of a 
general hospital by Hazel Wilson. Montreal, 
1968. 53p. Thesis (M.Sc.(App.)) - McGill. R 

65. A study to explore the relationship be- 
tween the consensus of perception of the roles 
of the head nurse and assistant head nurse in a 
hospital unit and to the stability of the unit by 
Mary Irene MacMillan. Montreal. 1968. 51 p. 
Thesis (M.Sc.(App.)) - McGill. R 

66. A study to determine who. in the 
opinion of nurses and physicians, should be re- 
sponsible for teaching the hospitalized patient 
by Shirley Jean Shantz. Seattle, Wash., 1968. 
138p. Thesis (M.N.) - Washington. R 

67. Theoretical basis for the teaching of eye 
nursing in a Peruvian diploma nursing program 
by Sister Leona Hebert. Saint Louis, Missouri, 
1967. 68p. Thesis (M.Sc.N.) - Saint Louis. R 

68. Timing studies of nursing care in relation 
to categories of hospital patients by J. Asa K. 
MacDonell, Unnur Brown and Barbara 
Johansson. Winnipeg, 1968. 162p. R 



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THE CANADIAN NURSE 55 



classified advertisements 



ALBERTA 



ALBERTA 



BRITISH COLUMBIA 



Opportunity for team teaching in nursing in a Junior 
College setting. INSTRUCTORS (3) to be appointed in 
1969 — one with Psychiatric Nursing preparation; 
and one with Pediatric or Maternal Child preporo- 
tion; and one other with either preparation. Qualifi- 
cation is Master's degree in clinical specialty pre- 
ferred. Bachelor's degree accepted for temporary 
appointment. Active and auxiliary hospital proviides 
clinical experiences. Total student enrollment of 70. 
Total staff of seven for nursing. Apply for further 
details to: Director, Department of Nursing Educa- 
tion, Red Deer Junior College, Red Deer, Alberta. 

REGISTERED NURSES FOR GENERAL DUTY in a 34- 

bed hospital. Salary 1968 $405-$485. Experienced 
recognized. Residence available. For particulars con- 
toct: Director of Nursing Service, Whitecourt General 
Hospital, Whitecourt, Alberta. Phone; 778-2285. 

Ganera) Duty Nurses for active, accredited, well- 
equipped 65-bed hospital in growing town, populo- 
tion 3,500. Salaries range from $405 — $485 com- 
mensurate with experience, other benefits. Nurses' re- 
sidence. Excellent personnel policies and v^orking 
conditions. New modern wing opened in 1967. Good 
communications to large nearby cities. Apply: Di- 
rector of Nursing, Brooks General Hospital, Brooks, 
Alberta. 

GENERAL DUTY NURSES (2) for snnall modern Hos- 
pital on Highwoy No. 12. East Central Alberta. 
Salary range $430 to $510 including Regionol 
Differential. Residence available. Personnel policies 
as per AARN and A.H.A Apply: Director of Nursing, 
Coronation Municipal Hospital, Coronation, Atbertc. 

GENERAL DUTY NURSES for 94bed General Hos 
pital located in Alberta's unique Badlands. $405- 
$485 per month, approved AARN and AHA per- 



ADVERTISING 
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Rates for display 
advertisements on request 

Closing date for copy and cancellation is 
6 w/eeks prior to 1st day of publication 
month. 

The Canadian Nurses' Association does 
not review the personnel policies of 
the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective oppliconts should apply to 
the Registered Nurses' Association of the 
Province in which they are interested 
in working. 



Address correspondence to: 

The 

Canadian ^ 
Nurse ^ 



50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 



sonnel policies. Apply to: Miss M. Howkes, Directo- 
of Nursing, Drumheller General Hospital, Drumhel- 
ter. Alberi=. 1-31-2A 



General Duty Nurses for 64-bed active treatmeni 
hospital, 35 miles south of Calgary. Salary range 
S405 - $485. Living cccommodaTion available in sep- 
arate resiaence if aesirsd. Full mainrencnce m 
residence S50.00 per month Excellent Personnel 
Policies and working conditions. Please apply ic: 
The Director of Nursing, High River General Hos- 
pital, High River, Alberto. i-46-lA 



GENERAL DUTY NURSES for 200-bed active treatment 
hospital. Salary S405-S485. Credit for pest experi- 
ence and postgraduate training. Employer-employee 
participation in medical coverage and superonnuo- 
rion. Apply: Director of Nursing Service, St. Michael's 
General Hospital, Lethbridge, Alberto. 

GENERAL DUTY NURSES (2) for modern, 25-bed ac- 
tive treatment hospital, 20 miles north of Lethbridge. 
Salary and personnel policies in accordance with 
the AARN and Alberta Hospital Association Recom- 
mendations. Residence facilities available. Apply to: 
Director of Nursing, Municipal Hospital, Picture 
Butte, Alberta. 



General Duty Nurses required by 150-bed general 
hospital presently expanding to 230 beds. Salary 
1967, $380 to $450; 1968 — $405 to $485. Experi- 
ence recognized. Residence available. For poriiculars 
contact Director of Nursing Service, Red Deer 
General Hospital, Red Deer, Albertc. 



General Duty Nursing positions are available in o 
lOO-bed convalescent rehabilitation unit forming 
part of a 330-bed hospitol complex. Residence 
available. Solory 1967 — $380 to $450. per mo. 
1968 — $405 to $485. Experience recognized. For 
full particulars contact Director of Nursing Service. 
Auxiliary Hospital, Red Deer, Alberta. 



BRITISH COLUMBIA 



DIRECTOR OF NURSING required for 30-bed hospital 
B.C. Interior. New 41-bed hospital in late planning 
stoge. New industrial activities will necessitate 
further exponsion. Apply with full particulars of 
training ond experience to; The Administrator, Lady 
Minto Hospital, Ashcroft, British Columbia. 



OPERATING ROOM INSTRUCTOR with University 
preparation, for a 450-bed hospital with a school of 
nursing, 145 students. Apply: Associate Director, 
School of Nursing, St. Joseph's Hospital School of 
Nursing, Victoria, British Columbia. 



COME TO PACIFIC NORTHWEST — Gateway to 
Alaska, Friendly community, enjoyable Nurses' Resi- 
dence accommodation at minimal cost. RNABC con- 
tract in effect. Salaries — Registered $508 to $633, 
Non-Registered $483, Northern differential $15 a 
month. Travel allowance up to $60. refundable 
after 1 2 months service. Apply to: Director of 
Nursing, Prince Rupert General Hospital, 551-5th 
Avenue Eost, Prince Rupert, British Columbia. 



B.C. R.N. for General Duty in 32 bed General Hospi- 
tal. RNABC 1967 salary rote $390 - $466 and fringe 
benefits, modern, comfortable, nurses' residence in 
attractive community close to Vancouver, B.C. For 
application form write: Director of Nursing, fraser 
Canyon Hospital, R.R. I, Hope, B.C. 2-30-1 



Cenoral Duty Nurses for active 30-bed hospital. 
RNABC policies and schedules in effect, also North- 
ern aliowonce. Accommodations avoiloble in res- 
idence. Apply: Director of Nursing, General Hospital, 
Fort Nelson, British Columbia. 2-23-1 

GENERAL DUTY NURSES (two). Fully accredited 25- 
bed hospital Rogers Pass Areo Trans Conoda High- 
way. Comfortable Nurses' Residence. RNABC Agree- 
ment in effect. 3 months allowed to gain B C. Regis- 
tration. Apply: Mrs. E. Neville, R.N., Director of 
Nursing, Golden & District General Hospital, P.O. 
Box 1260, Golden, B.C. 



General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in accordance with RNABC. Com- 
fortable Nurses' home. Apply: Director of Nursing, 
Boundary Hospitol, Grand Forks, British Columbia. 

GENERAL DUTY NURSES for 63-bed active hospital 
in beautiful Bulkley Valley. Booting, fishing, skiing, 
etc. Nurses' residence. Salory $466. -$490., main- 
tenance $70., recognition for experience. Apply: 
Director of Nursing, Bulkley Valley District Hospital, 
Smithers, British Columbia. 

General Duty Nurse for 54-bed active hospital in 
northwestern B.C. Salaries: B.C. Registered $405, B.C. 
Non-Registered, $390, RNABC personnel policies 
in effect. Planned rotation. New residence, room and 
board: $55/m. T.V. and good social activities. 
Write: Director of Nursing, Box 1297, Terrace, British 
Columbia. 2-70-2 

GENERAL DUTY AND PRACTICAL NURSE needed for 
70-bed General Hospital on Pacific Coast 200 miles 
from Vancouver. RNABC contract, $25. room and 
board, friendly community. Apply; Director of Nurs- 
ing, St. George's Hospital, Alert Bay, British Colum- 
bia. 

GENERAL DUTY, OPERATING ROOM AND EXPERI- 
ENCED OBSTETRICAL NURSES for 434-bed hospital 
with school of nursing. Salary: $508-$633, these 
rotes ore effective January 1969, plus shift differ- 
ential. Credit for past experience and postgraduate 
training. 40-hr. wk. Statutory holidays. Annual incre- 
ments; cumulative sick leave; pension plan; 20 
working days annuo I vacation; B.C. registration re- 
quired. Apply: Director of Nursing, Royal Columbian 
Hospital, New Westminster, British Columbia. 

GRADUATE NURSES required for 30-bed hospital in 
interior B.C. Salaries and conditions in accordance 
with RNABC agreement. Excellent accommodation 
available at an ottractive rate. Apply; Matron, 
Lady Minto Hospital, Ashcroft, British Columbia. 

GRADUATE NURSES for 24.bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel prac- 
tices in accord with RNABC. Accommodation avoilo- 
ble. Apply; Director of Nursing, General Hospital, 
Saucmish, British Columbia. 2-68-1 

Graduate Nurses for General Duty in modern 
225-bed hospital in city (20,000) on Vancouver 
Island. Personnel policies in accordonce with RNABC 
policies. Direct enquiries to: The Director of Nurs- 
ing, Regional General Hospital, Nanoimo, B.C. 

GRADUATE NURSES required for GENERAL DUTIES in 

small hospital in Southern B.C. Pleasant working 
conditions and recreational facilities available. Stort- 
ing salary $475 per month for B.C. Registered 
Nurses. Room and board $40 per month, ten statu- 
tory holidays, holiday and sick leave benefits. Apply 
giving full particulars of training, experience ond 
references to: Administrator, Slocan Community Hos- 
pital, New Denver, British Columbia. 



LABRADOR 



WANTED GENERAL DUTY NURSE for Churchill Falls, 
Labrador. Must be fluent in both English and French. 
For details pleose write: Miss Dorothy A. Plant, Inter- 
notionol Grenfell Association, Room 701A, 88 Met- 
calfe Street, Ottawa 4, Ontario. 



NOVA SCOTIA 



56 THE CANADIAN NURSE 



GENERAL DUTY NURSES: Positions available for 
Registered Qualified General Duty Nurses for 138- 
bed active treotment hospital. Residence occorri- 
modotion available. Applications and enquiries will 
be received by: Director of Nursing, Blonchard-Froser 
Memorial Hospital, Kentville, Nova Scotio. 6-I9-I 

GENERAL DUTY NURSES — registered, for 12-bed 
hospitol recommended salaries and work benefits. 
Apply to: Administrotor, Musquodoboit Valley Me- 
morial Hospital, Middle Musquodoboit, Halifax Coun- 
ty, Nova Scotia. 

JANUARY 1969 



February 1969 



The 



Canadian 
Nurse 






clinical laboratory procedures 



hyperbaric oxygen units 
- high pressure nursing 



student observation 
at postmortem exam 



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The 

Canadian 
Nurse 



^ 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 65, Number 2 



February 1969 



33 Epidermolysis Bullosa E. Melnyk 

37 Hyperbaric Oxygen Units — High Pressure Nursing G. Zilm 

41 Clinical Laboratory Procedures E.M. Watson, A.H. Neufeld 

57 Student Observation at Postmortem Examinations V.A. Lindabury 

59 Nursing Organization — Circa 1969 D.Y.Stewart 

62 Two- Year Versus Three- Year Programs C.G. Costello and 

Sister T. Castonguay 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

21 Names 

27 New Products 

65 Books 



7 News 

25 Dates 

30 In a Capsule 

70 Accession List 



Executive Director: Helen K. .Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editor: Loral A. Graham • Editorial Assist- 
ant: Carol A. Kotlarsky • Circulation Man- 
ager: Berjl Darling • Advertising Manager: 
Ruth H. Baumel • Subscription Rates: Can- 
ada: One Year. S4.50; two years, S8.00. 
Foreign: One Year, S5.00; two years, $9.00. 
Single copies: 50 cents each. Make cheques 
or money orders payable to the Canadian 
Nurses' Association, • Change of Address: 
Four weeks' notice; the old address as well 
as the new are necessary, together with regis- 
tration number in a provincial nurses' asso- 
ciation, where applicable. Not responsible for 
journals lost in mail due to errors in address. 
® Canadian Nurses' Association 1969. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
.Authorized as Second-Class Mail by the Post 
Office Department. Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4, Ontario. 



Editorial 



FEBRUARY 1%9 



Parliament's approval of Bill C-1 16, 
which, among other things, excludes 
professional publications from the 
benefit of second class mailing 
privileges ("News," p.7), came as a 
shock, if not as a surprise. 

For the Canadian Nurses' 
Association, whose publications 

THE CANADIAN NURSE and 

L'injirmiere canadienne probably will 
be affected by this new legislation, the 
postal boost comes at an inopportune 
time: CNA just does not have the 
money in this 1968-70 biennium to 
pay any additional mailing costs. 

At present, the combined cost of the 
two journals to each CNA member is 
$3.00 yearly. That is, out of the $10 
paid to CNA by each member 
annually, $3.00 is put aside for the 
operating expenses of the two journals. 
(In provincial associations whose 
membership exceeds 20,000, the 
annual fee per member in the 1968-70 
biennium is $6.) 

This is anything but an exorbitant 
cost for the publication of two 
professional journals. In fact, it is a 
minuscule amount when compared 
with the budget of other monthly 
publications of a similar size and 
nature. 

When the new postal rates are 
increased this April, annual mailing 

costs of THE CANADIAN NURSE and 

L'injirmiere canadienne will probably 
increase by $1 .80 per member. In other 
words, the total costs of the two 
journals to each CNA member will rise 
from $3.00 yearly to $4.80. 

This month, the CNA Board of 
Directors will examine the journals' 
financial plight and decide on the 
action to be taken. We believe that a 
special general meeting should be 
called to ask for an increase in the 
CNA membership fee. If CNA 
members believe there is value in 
having an Association journal, they 
must be willing to pay for it. — V.A.L. 

THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Back seat for human rights 

At one time a nurse was an adminis- 
trator of her own domain, in complete 
control, and completely responsible. She 
did rounds with the doctor and carried 
out his orders from a notebook with a- 
mazing precision. Most nursing care was a 
challenge to her and a satisfactory day's 
work. She used her own intuition and 
maturity coupled with common sense and 
experience. 

Today, science has advanced and the 
law is enforced. Human rights have taken 
a back seat and money and status have 
taken a front seat. The nurse has only to 
try and read the doctor's orders, sign her 
signature 50 times per day, and make sure 
it is the right one. She has to keep closed 
lips to abuse and misuse and smile like an 
idiot. 

Qualifications 1921: a registered nurse 
obtained a hospital diploma with as- 
surance, professional pride, and respect. 
Qualifications 1968: a registered nurse 
has the aim of a university degree at some 
state of senility and has a well informed 
theory of non-professional status until 
she reaches that stage. - C. Mooney, 
Vancouver. 

Needed: PR expert 

I take exception to the letter in the 
November issue in which a B.C. nurse 
criticized Monica Angus' article in the 
August issue. 

Surely this is what the provincial 
organizations of nursing have needed for 
years: if not a paid president, a paid 
public relations expert. 

In this day of rapid communications, 
immediate explanation of events stated 
precisely at the heiglit of public interest is 
mandatory. Only a well-paid public re- 
lations expert, well informed about the 
nurses' stand on financial matters es- 
pecially is able to give nurses rapid, in- 
tense results. As an R.N. of 14 years and 
a member of the Registered Nurses' As- 
sociation of Ontario. I cannot agree that 
senior staff members are cognizant of the 
problems of the staff nurse; if they are 
aware, they are too inarticulate or 
browbeaten by years of passive nurse- 
doctor relationships to fight for anyone. 

As examples, instances this past 
summer and fall when a "public re- 
lations" expert would have been useful 
are cited: 

1 . An article in the Globe and Mail 
about staff shortage at the new Scarbor- 
rougli Hospital, the use of part-time staff, 
and foreign nurse employment. 
4 THE CANADIAN NURSE 



2. The public health nurses' stand in 
Scarborough was broadcast on the nation- 
al news. Surely a follow-up on an after- 
noon women's show could have been at- 
tempted. 

3. The closing of a wing of a London 
hospital. 

4. The phasing out of small hospitals 
to make way for a regional hospital in the 
Grey County area. Ontario Hospital Com- 
mission members were interviewed, but 
where were the nurses? 

5. The recent hospital association 
meeting initiated snide remarks about 
hospital costs and staff expenses. Would 
the public not support us if they knew an 
R.N. has a take-home pay of less than 
many postal workers? 

6. The atrocious reporting on the 
Canadian Nurses' Association meeting. 
Probably the delegates were too ashamed 
to be interviewed about basic minimum 
salaries, since they couldn't agree on 
$7,000. 

7. The Commission on the Status of 
Women, deprecated on some television 
shows, for example, Hamilton Hot Line. 
Did any R.N. phone in or write to the 
announcer? 

8. The recent announcement that nursing 
instructors' salaries would be decreased in 
the London area. 

We need an aggressive, articulate, 
well-paid woman to communicate on 
many subjects. A national CNA expert 
could probably be utilized more economi- 
cally than nine provincial ones. We need 
coverage immediately, not one or three 
months after a nurses' meeting. Pre- 
ferably, our representative should not be 
an RN. Let's do better if we are going to 
have any girls in nursing 10 years from 
now. - R.N., Ontario. 



A nurse never stops working 

People often say: "Isn't that too bad. 
She just graduated from nursing, now 
she's getting married, and soon she will 
stop working to have a family." Little do 
they know how far they are from the 
truth! 

I graduated and got married in August 
1965. I worked in a newborn nursery for 
a year, took a postgraduate course in the 
care of the premature infant, and worked 
in a premature intensive care unit for 
another year. After that, my husband and 
I adopted a baby and I stopped working 
or so I thought! 

No sooner had I settled down to the 
routine of staying at home, than people 



in the apartment, knowing I was a nurse, 
started calling. 

First case a large sty in a little girl's 
eye. "Should I compress it? " asked the 
mother. "Should she stay home from 
school? " After consulting my trusty 
medical-surgical book, we decided what 
should be done. 

Soon after that, I was asked to remove 
a splinter from a little boy's foot and a 
tiny bug trapped in the corner of his 
sister's eye. Other questions were: "What 
should I give my husband for his cold? " 
"My baby is constipated. Is it all right to 
put brown sugar in the formula? " 

Often friends would call and ask 
questions about a relative's illness. "How 
long will he be in hospital? " or "Why did 
this happen? " I always had to be careful 
to find out what the doctor had told 
them and then try to enlarge on this. 

Several friends had premature babies. I 
usually sent a note with some helpful 
hints for when the baby came home 
about feedings, burping, clothing - things 
that nurses sometimes forget to tell these 
mothers and that the mothers never think 
of asking about. 

I think every nurse in the community, 
whether she works in a hospital or not, 
never really stops nursing. She is cons- 
tantly giving advice, answering questions, 
and bandaging cut fingers. She must, at 
all times, have a handy supply of gauze, 
tape, alcohol, and iodine, both for her 
own family and all the neighbors. 

Ask any housewife/mother/nurse and 
she will tell you: "My work is never 
done! " - Ruth Smellie, R.N., Calgary. 

Afraid to criticize 

We are bitteriy disappointed in Mr. 
Wedgery's letter in the December issue. 
We all know where the profession is going 
- downhill fast. This is mainly due to 
poor economic status, but it is also in- 
creased by hospital administrators who 
want to decrease hospital budgets, 
doctors who carp and criticize and have 
little empathy with the nurse, and en- 
croaching paramedical "professions" 
poorly trained but cheaper to pay as in- 
halation therapists. 

We are attacked in the hospital field 
and deserted by university colleagues 
who produce courses dealing in abstract 
sociological philosophies and semantics, 
and lack clinical data. 

We are clinical practitioners, be we in 
the hospital or public health field. We 
need pertinent medical data. The hospi- 
tals are not giving enough inservice edu- 
FEBRUARY 1%9 




cation to active nurses much less to semi- 
retired nurses. That is why we go to 
doctors' lectures. We need facile, succinct 
lectures. 

Why don't we attend meetings airing 
the ills of nursing? No nurse working in a 
hospital dares initiate any criticism at 
chapter meetings; the directors are sitting 
there glowering. Possibly one solution 
would be to divide meetings into groups 
of peers - a sad commentary on nursing, 
but too true. 

If Mr. Wedgery really wants to 
promote nursing discussion on the pro- 
fession, he should start group discussions 
on topics such as how can you - at this 
hospital — increase nursing salaries? But 
he should not criticize nurses interested 
in doctors' lectures. This is the mark of a 
profession: we are interested in growth 
and education. - Three Ontario R.N.'s. 

Tender loving care 

Is T.L.C. passe? Having been on the 
receiving end of nurses' professional ser- 
vices in various hospitals this past year I 
feel more than qualified to say how 
ashamed I am to call myself an R.N. 

Today's nurse seems more turned 
inward, concerned about working hours, 
salaries, vacations, and directing others to 
do her job. She has no time to help the 
multiple sclerosis patient on or off the 
bedpan, or give the necessary back care or 
mouth care. She is too busy for five- 
minute kindness. "Someone else will be 
in shortly" is an expression heard fre- 
quently. The paralyzed patient has tears 
running down her cheeks because the 
nurse takes too long with the necessary 
analgesic asked for one-half hour ago and 
she thinks she is forgotten. This could be 
you someday - a person in need whom 
no one seems to hear. Are you guilty of 
not caring? - Joyce Mossop, R.N., 
Thetford Mines, Quebec. 

Book about nurses 

I am preparing a book which will be a 
collection of short humorous stories 
about nurses and patients in hospitals, 
offices, and any other place where nurses 
come into contact with their patients. 

I would appreciate it if nurses would 
send me stories of humorous incidents 
that have happened to them and I will 
include them in my book. 

Fifty percent of the proceeds will be 
pledged to Oxfam Relief of Canada and 
the remainder of the proceeds will, I 
hope, cover my expenses. 

Nurses may send jokes, short stories, 
or incidents to me at: 5830 Cote St. Luc 
Rd., Apt. 2, Montreal 253. - Dawn 
Moynihan, R.N. D 

FEBRUARY 1%9 



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THE CANADIAN NURSE 5 




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6 THE CANADIAN NURSE FEBRUARY 1%9 



news 



Postal Rate Increases 

May Affect CNA Magazines 

Ottawa. - Mailing costs for the Ca- 
nadian Nurses' Association's magazines, 
THE CANADIAN NURSE and L 'mfimiere ca- 
nadienne, may increase by more than 15 
times the present costs when the new 
mail rates and classifications go into 
effect April 1, 1969. "If the magazines 
are required to pay the new third class 
rates, then the monthly costs of sending 
the magazines wUl rise from S770 to 
SI 1,072 for an average-sized issue," said 
Ernest Van Raalte, CNA General Manag- 
er. "Postage on returned journals and 
other direct mail costs would bring the 
total monthly postage to approximately 
$12,000."hesaid. 

"The new rates, if applicable to CNA 
magazines, would mean that an additional 
$135,000 would have to be found in this 
year's present CNA budget." Mr. Van 
Raalte said. "CNA has applied for ex- 
emption from this increase, but word 
from the Post Office Department has not 
yet been received." 

The Association, which agreed to hold 
its budget for the 1968-70 biennium to 
the 1966-68 figures, does not have the 
money to cover these increases without a 
major cutback in some other of its 
planned expenditures, Mr. Van Raalte 
told a reporter for the Canadian nurse 
The Board of Directors and the special 
Ad Hoc Committee on Functions, Re- 
lationships, and Fee Structure have been 
notified about the new rates and the 
possible effects, he said. This will enable 
the Board to make an interim decision 
about financing these additional costs at 
its meeting in February, he added, and 
the special committee, which was set up 
at the biennial meeting to investigate the 
questions of fees and the division of labor 
between the provincial and national as- 
sociations, can consider this additional 
financial problem before submitting its 
report. 

Helen K. Mussallem, executive director 
of CNA, says that if CNA has to pay the 
increase, she can see only three possible 
solutions. "We can cut back the present 
CNA programs to find the additional 
5135,000. or we can cut back and modify 
the present form of the CNA magazines, 
although that may mean a loss of 
advertising revenue; the only other alter- 
native would be to raise the money 
through increase of CNA fees at the next 
general meeting." she said. She pointed 
out that the Board will probably debate 
these alternatives at the Board meeting 

FEBRUARY 1%9 



beginning in Ottawa, February 1 1 . 

Several other professional journals are 
also facing the problem of the increased 
postal rates. Arthur Kelly, managing 
editor of the Canadian Medical Associa- 
tion Journal, was quoted in an Ottawa 
paper as saying that to continue, the 
CMAJ might have to become a monthly 
or semi-monthly publication, rather than 
continue as a weekly. Dr. Kelly said that 
he expected postal fees for the CMAJ to 
increase to Si 40.000 a year from the 
present SI 8.000. 

When Postmaster General Eric Kierans 
introduced Bill C-1 16. which included the 
changes in mail rates and classifications, 
he explained that the changes in respect 
to newspapers and periodicals had two 
main objectives, says a release from the 
Post Office Department. "The first is to 
take a long step toward assuring that 
second class mail pays its fair share of 
postal costs. The second objective is to 
modify and clarify the terms and con- 
ditions under which the statutory second 
class rates apply and thereby establish a 
more logical basis for determining en- 
titlement to second class privileges," says 
the release. 

These changes are mainly to exclude 
non-profit associations, which do not pay 
taxes, from qualifying for second class 
mail privileges. 

Canadian Printer & Publisher, the 
magazine of the Canadian printing indus- 
try, quoted the Postmaster General as 
saying, "Over the past 10 years alone, the 
Canadian public has disbursed a total of 
approximately S300 million to publishers 
by way of a subsidy on second class mail 
rates." 

The magazine goes on to point out 
later that two magazines. Time and 
Reader's Digest, both U.S. -owned and 
with low editorial costs because most of 
the material is shipped from the U.S. 
parent. wUl continue to enjoy the low 
rates and large subsidies. 

CNF Scholarship Fund 
Drops To $25,000 For 1%9 

Ottawa. ~ The Canadian Nurses' 
Foundation reports that approximately 
525,000 will be available for 1969 fellow- 
ship awards, less than half the amount 
awarded in each of the past two years. 

As of August 31, 1968, the balance in 
the scholarship fund was 513,000, and in 
the general fund SI 1,000. As all adminis- 
trative costs are met by the Canadian 
Nurses" Association, a transfer of SI 0,000 



from the general to the scholarship fund 
will be considered at the annual general 
meeting at CNA House. February 1 1 . 
Any significant donation before May 1 
could increase the amount available for 
scholarships. 

Two provincial organizations have 
announced their intention to make 
annual grants to CNF. The Registered 
Nurses' Association of British Columbia 
will make a per capita grant to the 
Foundation, the amount to be decided 
each year. The Alberta Association of 
Registered Nurses will contribute 51.00 
per member each year. 

Membership in the Foundation stood 
at 1,494 in August, 1968. Donations 
amounted to a total of 516,366 at the 
same date, including donations by indi- 
vidual members, provincial associations, 
and other groups. 

The general meeting in February will 
also consider reports of the Board of 
Directors, the secretary-treasurer, audi- 
tors, and committees, and discuss the 
establishment of the calendar year as the 
financial year of the Foundation. 

Special Ad Hoc Committee Meets 

Ottawa. - The first meeting of the 
special Ad Hoc Committee on Functions. 
Relationships, and Fee Structures was 
held at CNA House January 9 and 10, 
1969. The committee, generally dubbed 
the "Special Committee." was set up at 
the biennial general meeting of the Cana- 
dian Nurses' Association last June after 
considerable discussion on the questions 
of fees and of the divisions of labor and 
responsibilities between the provincial 
and national associations. 

Chairman Jean S. Tronningsdal told 
the Canadian nurse after the meeting 
that the committee has spent two very 
busy days and has made a good start. "We 
have a lot to do in a short period of 
time." said Mrs. Tronningsdal, "and we 
realize that we will have to pace our 
efforts. We must finish our task by 
Jjnuary 1970, so that the provincial 
associations can receive and study our 
report before the biennial meeting in 
June 1970." she explained. 

During the meeting, committee 
members agreed to appoint a secretary 
from the group on a rotating basis, Mrs. 
Tronningsdal said. Madge McKillop, 
University Hospital. Saskatoon, was given 
the task for this meeting. Marie Sewell. 
New Mount Sinai Hospital. Toronto, will 
(Continued on page 9) 
THE CANADIAN NURSE 7 



COUNIOOIMI TO GONERESS 




Only four months to go to the 
INTERNATIONAL COUNCIL OF NURSES' 
14th OUADRENNIAL CONGRESS 

Place Bonaventure, Montreal, Canada, 
22 to 28 June, 1969. 



PROGRAM HIGHLIGHTS: 

Sunday, 22 June 

3.00 p.m. Interfaith Service 

8.00 p.m. Opening Ceremony 



Monday and Tuesday, 23 and 24 June 
Open meeting of Council of National 
Representatives (CNR) 

Wednesday, 25 June 
"Focus on the Future" 
a.m. Plenary session — 

Forecasting the Future 
p.m. Plenary session — 

Implications of Change 

Thursday, 26 June 

"Focus on the Future" 

a.m. Plenary session — 

Education for Today and To- 
morrow. Basic Programs 

p.m. Plenary session - 

Education for Today and To- 



morrow. Post Basic and Post- 
graduate Programs 

5.00 p.m. Voting for ICN Officers by 
CNR 

8.00 p.m. Students' Congress 



Friday, 27 June 

"Focus on the Future" 

a.m. Plenary session — 

Security for Tomorrow 

p.m. Plenary session — 

Leadership in Action 

8.00 p.m. Closing Ceremony 

Admission of new member 
associations to ICN 
New ICN Officers 
announced 

Saturday, 28 June 
Canada Hospitality Day. 



N.B. 



* Special Interest Sessions - 19 topics in English and French, will be 
running Monday through Friday 

* International Nursing Exhibition - runs Monday through Wednesday 



FOR FURTHER IN FORMA TION, INCLUDING R EG 1ST R A TION 
KITS, PLEASE WRITE TO: 

ICN Congress Registration, 

50, The Driveway, 

Ottawa 4, Ontario. 



8 THE CANADIAN NURSE 



FEBRUARY 1%9 




(Continued from page 7) 

take on the secretarial duties at the next 
meeting. 

Mrs. Tronningsdal said that the next 
meeting of the committee has been set 
for May 8 and 9, 1969, at CNA House. In 
the meantime, the committee well seek 
information on certain specific matters 
from the provincial associations, the 
CNA, and CNA permanent staff 
members. 

Members of the committee include: 
Mrs. Tronningsdal, Miss McKillop; Miss 
Sewell: K. Marion Smith, Vancouver; 
Madeleine Jalbert, Quebec; Marilyn 
Brewer, Fredericton; Dorothy Wiswall, 
Halifax; Sister Mary Irene, Charlotte- 
town; and Elizabeth Summers, St. John's 
Nfld. Sister Mary Felicitas. president of 
the CNA, is a member exofficio. All 
members attended the meeting. 

An interim progress report will be 
presented to the CNA Board of Directors 
meeting in February, Mrs. Tronningsdal 
said. 

Several Reasons For Drop 
In Enrollment, Says RNANS 

Halifax. - Nova Scotia newspapers 
recently reported critical drops in the 
student nurse enrollment in the provincial 
nursing schools. Figures from the Reg- 
istered Nurses' Association of Nova 
Scotia support the reports. Only 264 
students registered in diploma schools 
this year, compared to 430 last year, 
reported Gertrude Shane, RNANS public 
relations officer. 

"However, there are several reasons for 
the decrease," Mrs. Shane added. 
"Although emphasis has been placed on 
the raising of standards, other factors are 
involved," she said. 

Michael MacDonald, director of the 
Nova Scotia Hospital Association, was 
quoted in the press saying that the 
entrance standards, raised this year by 
RNANS, had contributed to the drop. 

RNANS raised the educational require- 
ment for entrance to a school of nursing 
to grade 1 2 (equivalent to senior matric- 
ulation) from grade 1 1 . Mrs. Shane ex- 
plained that this was part of an overall 
program to improve nursing education in 
the province. 

RNANS has published several studies 
calling for reforms in nursing education 
during the past few years. Recom- 
mendations included the phasing out of 
diploma schools with less than 40 stu- 
dents, the adoption of a two-year 
program, improved curricula, and other 
changes. In Sydney, N.S., five hospital 
schools have suggested amalgamation 
into a central school. This would make 

FEBRUARY 1%9 



UR a PR for ICN, Says PRO 




Ottawa. - "Every Canadian nurse will need to be a public relations officer, if the 
International Council of Nurses Congress is going to succeed," Valerie Foumier, 
public relations officer for the Canadian Nurses' Association told her provincial 
counterparts at a recent meeting in Ottawa. The public relations officers from the 
10 provincial associations had gathered in Ottawa December 12 and 13, 1968 for a 
meeting devoted almost exclusively to discussions on public relations for the 
forthcoming ICN Congress in Montreal in June. The PROs were shocked at the low 
registration of Canadian nurses for the Congress. 

The PR Conference, the second which has brought public relations counterparts 
from all the provinces to Ottawa, discussed ways and means of promoting ICN in 
the provinces, and other matters, including division of duties between CNA and 
provincial PROs, when to start sending information to local media, and the 
organization of the press rooms at ICN. 

B.J. McGuire, of Forster, McGuire, Ltd., PR consultant to CNA and in charge of 
public relations for the ICN Congress, said that 100 to 150 media people, 
representing TV, radio, newspapers, wire services, magazines, and nursing press, are 
expected to be seeking information during the Congress. He explained the tentative 
plans for press facilities, and indicated areas where qualified public relations people 
would be needed. Six provinces have offered to send their public relations staff 
member to Montreal to assist CNA with staffing press rooms during the Congress. 
Peter Regenstrief. newspaper columnist, TV communicator, and professor of 
political science at the University of Rochester, Rochester, N.Y., was guest speaker 
during the Thursday afternoon session. 



better use of existing facilities and of 
qualified faculty. 

She said that nursing must compete 
for the best students with other pro- 
fessions, such as teaching, social work, 
and paramedical fields. Greater numbers 
of students are entering the university 
program. Requirements now are the same 
for both the diploma and the degree 
courses in the province. 

Another factor in the drop in enroll- 
ment in the nursing schools might be the 
low pay rates for nurses in the province, 
Mrs. Shane said. "Young women of the 
kind we need at the bedside are aware 
that salaries in nursing are lower than in 
other fields. Dedication alone will not 
attract the caliber of student who can 
cope with today's medical advances and 
modem hospital techniques," she said. 

Mrs. Shane added that the executive of 



the Association is concerned about the 
drop and will consider all aspects of the 
matter at its next meeting. 

Registration Picks Up 
As Cut Off Date Nears 

Ottawa. - Canadian registration for 
the forthcoming Congress of the Inter- 
national Council of Nurses picked up 
rapidly as the deadline for full regis- 
tration approached. Harriet Sloan, the 
Canadian Nurses' Association's coordi- 
nator for the ICN Congress, reported that 
as of January 10, 1969. 756 Canadians 
had registered for the international meet- 
ing. 

"This is nowhere near the 2,000 Cana- 
dians that we expect will be registered by 
June, but it is picking up rapidly now," 

(Continued on page 10) 

THE CANADIAN NURSE 9 




(Continued from page 9) 
Miss Sloan said. "However, it does rep- 
resent a jump of 286 during the week 
from January 3 to 10," she said. 

The last day for full registration privi- 
leges was January 22. Nurses can still 
register. Miss Sloan points out, but the 
fee has risen from $40 to $60. 

Breakdown of registration up to 
January 10, 1969 is: 

British Columbia 54 

Alberta 44 

Saskatchewan 16 

Manitoba 34 

Ontario 280 

Quebec 247 

Nova Scotia 1 1 

New Brunswick 29 

Prince Edward Island 2 

Newfoundland 1 

718 
Students 38 

Total 756 



CNA Sends Suggestions 

To Task Force on Information 

Ottawa. - In answer to a request from 
the federal government's Task Force on 
Government Information, the Canadian 
Nurses' Association submitted four sug- 
gestions in December for improving the 
government's information services. 

Helen K. Mussallem, executive director 
of the CNA, made the suggestions in a 
letter to D'Iberville Fortier, chairman of 
the Task Force. In it she said that the 
government information services should 
have facilities and personnel to: 

• collect and publish data relevant to 
the supply of adequate nursing personnel 
for the long-term needs of Canadians; 

• produce and disseminate information 
on the nursing profession for the use of 
high school guidance counselors and 
others to encourage the entry of students 
into the profession; 

• respond to enquiries from foreign 
nurses regarding emigration to Canada to 
practice nursing; 

• notify CNA about planned gov- 
ernment activities concerning nurses to 
encourage participation by nurses and to 



Sub-Committee On Occupational Health Meets in London 




London, England. - The first meeting of the Nursing Sub-Committee of the 
Permanent Commission and International Association on Occupational Health was 
held in London, October 21 to 26, 1968. 

The Sub-Committee was established in Vienna in 1966, to gather information on 
the preparation and experience of occupational health nurses throughout the world, 
and to prepare reports to help countries raise standards of occupational health 
nursing. Reports of the meetings will be presented at the sixteenth congress of the 
Permanent Commission and International Association on Occupational Health in 
Tokyo in September, 1969. 

The Permanent Commission and International Association on Occupational 
Health was established in 1906 in Milan, Italy, and for many years remained an 
organization of specialist physicians. Nurses were invited to present papers to its 
meetings for the first time in 1948, but it was not until 1963 that the first Canadian 
nurse member was accepted. By 1968 there were four Canadian nurse members. 

The London meeting of the Nursing Sub-Committee raised its membership to six 
from the five established in Vienna by admitting another American member. From 
left to right they are: Ruth Sayanjarvi (Finland), Sally Wagner (USA), Mary 
Blakeley (UK), Sarah Wallace (Canada), Gunnell Pramberg (Sweden), and Mary 
Louise Brown (USA). 



10 THE CANADIAN NURSE 



minimize duplication of effort. 

The Task Force on Government In- 
formation, which will submit its re- 
commendations by March 1, 1969, was 
commissioned to study the structure, 
operation, and activities of federal de- 
partmental information organs in Canada 
and abroad. It will make re- 
commendations to the government on 
ways communication can be improved by 
the government's information services. 

AV-AIDS For Nursing 
Subject Of US Study 

New York. - A survey to provide 
information about audiovisual materials 
available for nursing is underway in the 
United States. The study, which will help 
the American Nurses' Association- 
National League for Nursing Film Service, 
is supported jointly by the U.S. Depart- 
ment of Health and the two nursing 
associations. 

The Health Department will provide 
$49,056 to the study for one year and 
the nursing organizations will contribute 
$8,930, bringing the total amount for the 
project to $57,986. 

A survey questionnaire will be sent to 
users and producers of nursing audio- 
visual materials. It will concern 16 mm 
and 8 mm film, filmstrips, videotapes, 
slides, audiotapes, computer instruction 
programs, and recordings. A list of all 
materials reported and a list of those 
recommended for use in schools of nurs- 
ing and health agencies will be prepared. 

OR Nurses Discuss 
Infection in Hospitals 

Montreal. - Asepsis was the main 
topic of discussion at the tenth annual 
meeting of the Operating Room Nurses of 
Quebec, held October 30 and November 
1, 1968, in Montreal. 

Lucette Lafleur, bacteriologist at 
L'Hopital Sainte-Justine, Rene Roux, 
surgeon at I'Hotel Dieu, Montreal, and 
Claude Morin, clinical instructor at 
L'Hopital Notre-Dame, Montreal, partic- 
ipated in a panel discussion entitled 
"Asepsis in the Operating Room." A 
question and answer period after the 
panel presentation enabled the audience 
to participate. 

Dr. Lafleur attributed the recurring 
problem of infection to the increasing 
numbers of new operations, such as neu- 
rosurgery, spare parts surgery, and some 
heart surgery. She suggested several 
methods for improving techniques, inclu- 
ding use of hexachlorophene or detergent 
in cleaning and, when possible, fumi- 
gation of the theatres. Contamination ol 
air in the operating rooms depends on the 
number and length of the operations, she 
said, adding that it would be necessary tc 
remove all air from the room to sterilize 
(Continued on page 14, 
FEBRUARY 1%*» 




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Five si:es designed to meet all infants' needs from 
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Single use eliminates a major source of cross-infection. 
Invaluable in isolation units. 



In providing greater hospital convenience: 

Polywrapped units are designed for one-day use, and 
for convenient storage in the bassinet. Also, Saneen 
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than autoclaved cloth diapers. • 
Prefolded Saneen disposables eliminate time spent 
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Elimination of diaper misuse, which may occur with 

cloth diapers. »Thc U-Richc Bacteriology Study— 1963 



More and more hospitals are changing to Saneen Flushabyes disposable diapers. 

Write us and we will be glad to supply you with further information on clinical studies, cost analysis, and disposal techniques. 

Use these and other fine Saneen products to complete your disposable program: 

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VISUAL AIDS 



Lippincotf 



FILM LOOPS 

in Fundamentals of Nursing 



An economical, efficient, time-saving method of 
teaching basic nursing skills and technics 

About film loops 

LIPPINCOTT loops are short (3-4 minutes) s/7enf motion 
pictures in color, permanently loaded (no threading) on 
a continuous reel or "loop." The use of Super 8mm. 
film and the Technicolor 810A Projector assure instant 
projection of clear, bright pictures. 

Easy to use 

Each loop is enclosed in a rigid plastic cartridge. You 
simply snap the cartridge into the small projector, turn 
the knob and the film is on. The loops may be started 
or stopped at any point. This allows the instructor 
flexibility in emphasizing key points in the classroom, 
and permits the student, when viewing the film without 
the instructor, to stop the film and carefully study any 
procedure she has trouble grasping. 

Easy storage and handling 

Collections of loops may be placed anywhere: class- 
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accessible library of loops— and the projector which is 
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immediate demonstration in any location. 

Advantages of this teaching medium 

In the classroom: Instructors can reinforce their 
lectures and eliminate repeated demonstrations. 
Because of the remarkable close-up lens, each 
student is able to see a demonstration as if she 
were standing next to the instructor. There is no 
problem of a large percentage of students not close 
enough to "see how it was done." 

For self-Instruction: Students can view and quickly 
review material, according to their individual needs 
and at a time and place convenient to study. A 
skilled demonstration is immediately available for 
the nursing laboratory, the library, or the nursing 
station. 

LIPPINCOTT'S Film Loops in Fundamentals of Nursing 

BED MAKING 

Making an Unoccupied Bed, 

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Making an Occupied Bed, 

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Manipulation of Linen, 

Parts I and II complete, $47.50 
HYGIENE 

Bed Bath, Parts I and II complete, $47.50 

Back Rub $23.75 

Care of Dentures $23.75 

12 THE CANADIAN NURSE 




TECHNICOLOR SUPER MOVIE PROJECTOR 
Model 810A $229.95 




POSITIONING AND EXERCISE 

Prevention of External Rotation 

(Trochanter Roll) $23.75 
Prevention of Drop Foot, 

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Preparation of an Injection from a Vial $23.75 
Preparation of an Injection from an Ampule $23.75 
Preparation of an Injection from a Tablet $23.75 
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Lateral Thigh $23.75 
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Selection of Site for Intramuscular Injection: 

Dorsogluteal $23.75 
Administration of an Intramuscular Injection: 

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Prices for film loops include instructor's manuals and student guides. 

Additional loops in preparation 

Let us show you what this valuable new teaching aid 
can do! A detailed catalog covering Lippincott Loops 
and the Technicolor Projector will be mailed to you 
upon receipt of filled-in coupon on opposite page. 

FEBRUARY 1% 



TO LEARNING 



Lippincott 



MULTICOLOR TRANSPARENCIES 

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MAKE LEARNING MORE EFFECTIVE 



MAKE CLASSES MORE EXCITING 



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This teaching tool offers numerous advantages: 

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Units can be presented in any sequence and at 
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Instructors can use marking pencils (easily eras- 
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Part of a transparency can be exposed as desired, 
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Anatomy and Physiology (142 transparencies; 519 
overlays) $632.50 

Inhalation Therapy (89 transparencies; 92 overlays) 

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The Patient and Circulatory Disorders (54 transparen- 
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The Patient and Fluid Balance (64 transparencies; 
158 overlays) $382.00 

Also Available: 

Fundamental Nursing Principles (159 transparencies; 

89 overlays) $718.00 

Applied Mathematics: (Unit I) Metric System & 



Apothecaries Equivalents (12 transparencies; 5 over- 
lays) $62.00 

Applied Mathematics: (Unit II) Preparing Solutions, 
Calculating Amount of Solute and Solvent (12 trans- 
parencies; 26 overlays) $79.00 

Applied Mathematics: (Unit 1 1 1) Calculating Drug Dosage 
(12 transparencies; 36 overlays) $90.00 
First Aid (52 transparencies) $135.00 
Mouth to Mouth Resuscitation: (10 transparencies; 
15 overlays) $37.50 

Bandaging and Splinting (103 transparencies) $268.80 
Emergency Surgery (220 transparencies) $545.00 
Emergency Childbirth (51 transparencies) $112.00 
Dental Hygiene (23 transparencies) $82.50 
Each Series includes an Instructor's Manual 



TRAVELGRAPH Overhead Projector 
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A word about the Lippincott guarantee . . . 

Every transparency and overlay is fully guaranteed not 
to peel, chip, discolor, or fade. If any of these conditions 
occur, the transparency will be replaced free of charge. 
To help you select the units best suited to your curricu- 
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J. B. LIPPINCOTT COMPANY OF CANADA LTD., 60 Front Street West, Toronto 1, Ontario 



1— 

Please send me the following 


material: U Complete film loop catalog 


Transparency brochures as checked: 


1 n Anatomy and Physiology 
1 n Inhalation Therapy 
1 D The Patient and 
j Circulatory Disorders 
D The Patient and 
Fluid Balance 


□ Fundamental Nursing Principles 
U Applied Mathematics: Unit 1 
n Applied Mathematics: Unit II 
n Applied Mathematics: Unit III 
n First Aid 
Q Mouth to Mouth Resuscitation 


[J Bandaging and Splinting 
u Emergency Surgery 
□ Emergency Childbirth 
n Dental Hygiene 
n The VISUALCAST Overhead 
Projector 


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EBRUARY 1%9 



THE CANADIAN NURSE 13 



ARNN Moves To New Headquarters 




St. John's. - Staff of the Association of Registered Nurses 
of Newfoundland have moved into their new building in 
Central St. John's and are making preparations for the 
official opening to take place early in April. The new 
offices, adapted from a two-story family home, were 
purchased last fall by the ARNN at a cost of $35,000. 

The main floor has been altered into a large Board 
Room with an adjoining office for the president, a main 
office area for permanent, professional staff, and a general 
work area for secretarial staff. Upstairs, there are five 
rooms; one has been established as a library and one has 
been turned over to the Newfoundland Student Nurses' 
Association. The ARNN may rent the others until the 
space is needed. 

"After our old, desperately-crowded quarters, the staff 
appreciate the larger amount of space," said PauUne 
Laracy, ARNN executive secretary. "It is pleasant to no 
longer have to stack boxes on top of boxes, or on the 
floor, or on desks, or anywhere space could be 
discovered." 

The photograph shows the executive and staff in front 
of the new ARNN building on moving day last September. 



UNM Elects New Officers 




Montreal. - The United Nurses of Montreal elected 
new officers to the executive committee and board of 
directors at their annual meeting, November 29. Wendy D. 
Rogers (center), continuing UNM president, welcomes 
Mary Anne Adams (right), of The Montreal General 
Hospital, who was elected first vice president, and Monika 
Berlage, Montreal Children's Hospital, secretary. 

Newly elected directors of the executive committee 
are: Audrey Crouse, Royal Victoria Hospital; Liz Ireton, 
Montreal Children's Hospital; and Janet Funke, St. Mary's 
Hospital. 

Newly elected officers of the Board of Directors are: 
Carolyn Robertson, Montreal Neurological Institute, as 
first vice-chairman; Hilda Dariington, Lakeshore General 
Hospital, secretary; and Mary Costello, Montreal Chil- 
dren's Hospital, Shirley Alexander, Royal Victoria Hospi- 
tal, and CoUeen McGillvary, Jewish General Hospital, 
directors. 

Margaret Masters, Jewish General Hospital, continues 
as chairman of the board of directors. 



(Continued from page 10 j 

it completely. Some control of air con- 
tamination is obtained by limiting the 
number of people entering and leaving 
the operating room, and by restricting the 
number of unnecessary movements, and 
reducing talking to a minimum. 

Dr. Roux suggested the operating area 
could be divided into three sections: an 
inner aseptic area that would be the 
operating theatre; an intermediate area 
for scrubbing; and an outer general ex- 
change area. Entrance to any of these 
three operating areas would require a 
change to OR garb. Dr. Roux recalled the 
Canadian Hospital Accreditation Board's 
recommendations, and advised that each 
hospital study its own special problems of 
infection and particular needs. He also 
recommended the establishment of a 
committee to investigate the problem of 
infection in hospitals. 

Miss Morin spoke of a plan to prepare 
nurses and other hospital personnel for 
their operating room tasks. She em- 

14 THE CANADIAN NURSE 



phasized the need for knowledge of 
asepsis by all personnel in the hospital. 



Montreal Nurses Sign Contract 
With Queen Elizabeth Hospital 

Montreal. — A contract reducing the 
work week from 40 hours to 36-1/4 
hours was signed by the United Nurses of 
Montreal and the Queen Elizabeth Hospi- 
tal in Montreal, November 15, 1968. In 
addition to the reduced hours, nurses 
working on the night shift will have 
coffee breaks and one extra day off in 
every seven worked to compensate for 
the meal periods given in the day shift. A 
nurse in charge of a unit on evening or 
night shifts will receive an extra 65 cents 
per shift in addition to the premium for 
that shift. 

The new contract also stipulates that 
credit for previous experience of a new 
employee will be determined on the basis 
of experience in nursing acquired in 
hospitals or in public health nursing 



witliin the past 1 years. The starting rate 
will be determined by completed years of 
experience. Annual increments will be 
given at the completion of each year of 
experience. The first annual increment 
will be given on the completion of an 
additional year, comprising months prior 
to employment by the hospital and those 
completed in the hospital. Future in- 
crements will be given on the anniversary 
of the date of this first increment. 

The contract was negotiated by Wendy 
Rogers, president of UNM, and Margaret 
Stead, executive secretary. The UNM is a 
union of professional nurses formed in 
1966 by the English Chapter, District XI 
of the Association of Nurses of the 
Province of Quebec. 



Electronic Video Recording 
Simplifies Film Showing 

New York. - A new method of storing 

and playing audiovisual material foi 

(Continued on page 16 

FEBRUARY ^W. 



Used by more than 80,000 nurses- 

Sutton's Bedside Nursing Techniques in Medicine and Surgery 

is one of the most widely used books of its type ever published. 
Now it has been completely revised and updated in a new Second Edition. 



A valuable source book of advanced clinical nursing techniques, this popular text has 
now been made even more valuable in the new revised Second Edition, now in press. 
The newest concepts of hospital care, the latest equipment, currently preferred medi- 
cations and diets, and the most recent diagnostic and therapeutic methods in medicine 
and surgery — all are explained in this new edition. In clear, precise language supple- 
mented by more than 750 explicit drawings, Mrs. Sutton tells precisely how to perform 
hundreds of nursing functions — from intramuscular injection to caring for the patient 
in hyperbaric oxygen therapy. Among the new material in this revised edition are 
sections on: 



Reverse isolation 
IPPB respirators 
Hypodermoclysis 



Tubeless gastric analysis 
Fluid and electrolyte balance 
Heart transplants 
Controlling hemorrhage from esophageal varices 
Intra-arterial infusion of anticancer agents 



In the first part of the book. Mrs. Sutton describes the basic techniques that are 
common to all areas of clinical nursing. Then she takes up the more specialized 
techniques used in disorders of each of the body systems. This arrangement provides 
a natural division that corresponds to that of the nursing specialties. Each of these 
chapters is subdivided under such headings as Diagnostic Procedures, Therapeutic 
and Rehabilitative Procedures, Additional Procedures to Review, Diets to Review, 
and Medications to Review. 

Nurses by the tens of thousands have found "Sutton" unparalleled as an advanced 
text, as a "refresher," and as a reference at the nursing station. It is even more valuable 
in the new revised edition. Reserve your copy now! 

By Audrey Latshaw Sutton, R.N., formerly Director of Nursing Service. Edgewood 
General Hospital, Berlin, N.J.; Instructor, Wilmington, Del., General Hospital. 



About 460 pages with about 760 illustrations. About $9.20. Ready March. 



W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 

Please reserve in my name a copy of Sutton's Bedside Nursing Techniques in Medicine and Surgery, 
(about $9.20) to be sent and billed when ready. 




Name: 
Address: 
City: 



Zone: 



Province: 



'EBRUARY 1%9 



CN 2-69 
THE CANADIAN NURSE 15 



news 



(Continued from page 14) 
hospitals, schools, and home has been 
introduced by the Columbia Broadcasting 
System. The Electronic Video Recording 
system stores 52 minutes of film in a 
cartridge seven inches in diameter, and is 
simple enough for a child to operate. 

EVR records pictures and sound much 
as long-playing records store sound. The 
system consists of the thin film stored in 
the cartridge, and a player that transfers 
the sound and pictures to a standard 
television set. 

Despite the small size of the film, 
pictures will be clearer than the conven- 
tional television picture, and there will be 
no interference or "ghost image" because 
the system is connected directly to the 
television set. The film is stored with a 
thin layer of air between each layer of 
film to protect it from damage by dust 
and dirt, and cannot be torn because 
there are no sprocket holes. 

The EVR player is attached to the 
television antenna terminals by handclips. 
The cartridge is placed on the player, the 
television is turned to a channel that is 
not broadcasting, and the starter button 
pushed. The film is automatically thread- 




FOR WOMEN ONLY 
. . . LAXATIVE NEWS! 

"When I think of the suffering I could 
have avoided if I'd known about COR- 
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it and we've found it fine for every age 
group from Grandma to ten-year-old 
daughter." — Mrs. E.H. 
CORRECTOL has been specially developed 
for a woman's delicate system. Its secret 
is a non-laxative regulator that simply 
softens waste. And, CORRECTOL contains 
just enough mild loxatiye to give regu- 
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two gentle ingredients in CORRECTOL 
give a womon effective relief, even fol- 
lowing childbirth. 

CORRECTOL 

*reg'd. T.M., Pharmoco (Canada) Ltd. 




Montreal. - Graduates of the University of Montreal Faculty of Nursing met 
November 2 and 3, after the annual meeting of the Association of Nurses of the 
Province of Quebec, to form an alumni association. The meeting, held in the 
auditorium of city hall, had been planned since July. After considerable debate, it 
was agreed that graduates of ITnstitut Marguerite d'Youville, which became part of 
the University of Montreal in June 1967, would be able to become members. 
Officers elected at the meeting are, left to right: Huguette Pelland, treasurer; 
Claudette Beauchemin, vice-president in charge of public relations; Ginette Roger, 
president; Sister Denise Lafond, secretary-archivist; Sister Rachel Rousseau, 
secretary-registrar. Absent is Lisette Arcand, vice-president. 



ed, and can be advanced or rewound 
rapidly, slowed for careful viewing of a 
particular scene, or frozen altogether. The 
system can be operated in normal light, 
and there is no projector noise to distract 
viewers. 

Hospitals and schools are expected to 
be among the first purchasers of EVR 
because of its value in education. It will 
make films easier to show and store, and, 
since it can be operated in normal light, 
notes can be taken from the films. The 
same film can be hooked to several 
television sets, so that a large number of 
students can see the films. 

Although EVR was developed by CBS 
as an offshoot of the space research it is 
conducting for the US government, the 
system will be manufactured by Motorola 
Inc. Educational films will be handled by 
Tfie New York Times Book and Educ- 
ational Division. 

The first black and white model of 
EVR should be ready for the market by 
July, 1970. The first color model is 
expected to be produced by the second 
half of 1971. Exact costs of the system 
have not yet been announced. 

Work Progressing For 
Standardized Terminology 

Ottawa. - The National Working Party 
on Standardization of Terminology in 
Hospitals has continued to hold bi- 



monthly meetings since its inception in 
February 1968. 

The Working Party was established 
under the sponsorship of the Department 
of National Health and Welfare and the 
Canadian Hospital Association to develop 
standardized terminology relating to 
various aspects of hospitals and hospital 
personnel. Its 1 5 members come from the 
Dominion Bureau of Statistics, various 
professions, hospitals, and provincial 
hospital insurance plans throughout the 
country. 

Donald F. Moffatt, consultant in ho- 
spital administration with the Depart- 
ment of National Health and Welfare, and 
chairman of the Working Party, told 
THE CANADIAN NURSE that he expects a 
glossary of terms to be produced in about 
a year. The Working Party has held five 
three-day meetings so far. 



RED CROSS 



IS ALWAYS THERE 



withYOURhelp 



m 



16 THE CANADIAN NURSE 



FEBRUARY 196? 



^ fti 



V- 



h 




your 

Own 

hands: 




..w***' 



soft testimony to your patients' comfort 

Your own hands are testimony to Dermassage's effectiveness. Applied by your 
soft, practiced hands, Dermassage alleviates your patient's minor skin irritations 
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned 
skin; relieves dryness, itching and cracking ...aids in preventing decubitus 
ulcers. In short, Dermassage is "the topical tranquilizer". , . it relaxes the patient 
. . . helps make his hospital stay more pleasant. 

You will like Dermassage for other reasons, too. A body rub with it saves your time 
and energy. Massage is gentle, smooth and fast. You needn't follow-up with 
talcum and there is no greasiness to clean away. It won't stain or soil linens or 
bed-clothes. You can easily make friends with Dermassage— send for a sample! 

Now available in new, 16 ounce plastic container with convenient flip-top closure. 



M^mA^ -jLiuyJLay a<UO~ttiJt'tAjU JUljk^U.'vut^ 



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EBRUARY 1%9 



LAKESIDE LABORATORIES (CANADA) LTD. 
64- Colgate Aven ue • Toronto 8, Ontario 

THE CANADIAN NURSE 17 




> t 



i% m- 




Quick-change 



artist 




The new Uromatic' 
plastic irrigating system 
for quicker hook-ups 

Sets-up fast, changes fast. That's uromatic plastic 
irrigating container. The new plastic irrigation solu- 
tion container that stops irrigation procedures from 
becoming irritation procedures. They're lighter, easier 
to handle, and safer to hong than conventional gloss 
bottles. Now every procedure is a safe procedure. 

The UROMATIC container changes everything but 
the technique. 

Three special ports let you use familiar 
techniques. But there is one big dif- 
ference. No troublesome metal 
closures or cops. Set-ups and 
change-overs are faster and 
more aseptic than ever before. 
As you insert the set, the spike 
completely occludes the 
administration port opening 
before it punctures an inter- 
nal safety seal. No fluid 
escapes. No air enters. It's 
automatic. The second port lets 
you add supplemental solutions 
when required. Or may be used 
for series hook-ups. A third, middle 
port may be clipped for use as a 
convenient pouring spout. From set con- 
nection through bottle change-over, it's the 
smoothest procedure available. 

And the safest. You'll wonder where the vent went. 
And why. The uromatic container doesn't need it. 
Atmospheric pressure produces flow. A dependable, 
continuous flow. There's no vent to clog or leak and 

disrupt the entire procedure. And no vent, no air. Air- 
borne contaminants are locked out. Safety is locked in. 

These are just some of the features you should 
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The uromatic plastic irrigation container. 
Irrigation without irritation. 



IMITED 



Now available 

THE SECOND EDITION OF 

COUNTDOWN 

CNA'S YEARBOOK OF CANADIAN NURSING STATISTICS 



One-third larger than last year's edition, COUNT- 
DOWN 1968 contains commentary and 133 sta- 
tistical tables updated to present the latest 
available data on nursing manpower, education, and 
salaries. 

An exciting addition this year is the inclusion of 
salaries paid to nurses employed in public general 
hospitals throughout Canada. 

A cross-reference between COUNTDOWN and 
FACTS ABOUT NURSING, published by the 
ANA, is available from CNA. 

Act now. Continue your collection of COUNT- 
DOWN with the 1968 edition by clipping and 
mailing the coupon below. 



TO: Canadian Nurses' Association 
50 The Driveway 
Ottawa 4, Ontario 



Please send 

per copy, to: 

Name 



(no. of copies) of Countdown 1968, at $4.50 



Address 


Citv 




Province 




Position 






Money Order D 


Cheque D 


For$ 


Enclosed 




COUNTDOWN 




A S S C C 



20 THE CANADIAN NURSE 



FEBRUARY 1969 



names 




Margaret E. Steed 
(Reg.N.. Toronto 
Western H.: Cert. 
Teaching & Superv., 
B.N., McGUl U.; 
M.A., Columbia U., 
New York) has been 
appointed by the 
University of Alber- 
ta as consultant to 
schools of nursing in Alberta. 

Prior to this appointment. Miss Steed 
was consultant in education, Canadian 
Nurses' Association, a position she held 
from 1964 to 1968. As education con- 
sultant. Miss Steed visited schools of 
nursing all over Canada on a consulting 
basis. She also served as secretary for the 
International Council of Nurses Exchange 
of Privileges program that sponsored in- 
ternational nurse visits. 

In her new position. Miss Steed re- 
places Marguerite Schumacher, now direc- 
tor, department of nursing education at 
Red Deer Junior College, Alberta. Miss 
Steed will be responsible for consulta- 
tions and visits to schools of nursing in 
Alberta, and for organizing workshops 
and continuing education programs for 
nurses and nursing instructors. 

Miss Steed taught for many years in 
the school of nursing at Toronto Western 
Hospital. From 1956 to 1962 she was 
assistant director of nursing at Kitchener- 
Waterloo Hospital. 



Sister Elizabeth F. Hurley (R.N., St. 
Joseph's H.. Saint John. N.B.: B.Sc.N., 
Seattle U.. Wash.) recently was appointed 
director of nursing service at St. Vincent's 
Hospital in Vancouver. Sister Elizabeth 
formerly worked as a staff nurse at St. 
Joseph's Hospital in Saint John, New 
Brunswick and as supervisor at St. Vin- 
cent's Hospital in Vancouver. 

M.Kathleen Logan (R.N.. St. Joseph's 
H., Saint John. N.B.; Dipl. Teaching, 
B.N., Dalhousie U.) has been named as- 
sistant director of nursing at St. Vincent's 
Hospital. Miss Logan formerly worked as 
general duty nurse at St. Joseph's Hospi- 
tal. Saint John, New Brunswick and in 
the Montreal Neurological Institute. 

Margaret Isobel Schaap (R.N., Regina 
General; Cert. Teaching & Superv., U. 
Manitoba) is the new director of nursing 
at Winnipeg Municipal Hospital. Previous 
to her appointment. Mrs. Schaap worked 
at Municipal Hospital as a general duty 
FEBRUARY 1%9 



and head nurse, and as assistant director 
of nursing. Mrs. Schaap has also held po- 
sitions at Regina General Hospital, Onta- 
rio Hospital in Woodstock, St. Joseph's 
Hospital, Winnipeg, and the Shriners 
Hospital for Crippled Children in Win- 
nipeg. 



Florence M. Fleming (B.A., U. Alber- 
ta; R.N., Vancouver General; Cert. Nurs- 
ing Service Admin., U. Toronto) edu- 
cation secretary of the Registered Nurses' 
Association of British Columbia since 
September 1964, retired on December 
31, 1968. 

After receiving her Bachelor of Arts 
(in Science) degree. Miss Fleming attend- 
ed the Normal School in Calgary and 
taught in Alberta higli schools for eight 
years. 

For ten years after her graduation 
from The Vancouver General Hospital 
School of Nursing, she worked in that 
hospital first as a general duty nurse and 
later as assistant night supervisor and ex- 
ecutive assistant in the department of 
nursing. 

Miss Fleming was an instructor at The 
Vancouver General Hospital School of 
Nursing for 1 1 years before joining the 
RNABC professional staff. 



Corps until 1946 and was awarded the 
Associate Royal Red Cross Medal. 




Ruth E. McIIrath 
(R.N., Winnipeg 
General H.) has been 
appointed director 
of nursing at Shaugh- 
n e s s y Veterans 
Hospital in Vancou- 
ver. She joined the 
staff of the hospital 
as supervisor in May 
1947 and became assistant director of 
nursing service in 1961. 

After graduating from Winnipeg Gen- 
eral Hospital School of Nursing in 1936. 
Mrs. McIIrath was a staff nurse and then 
supervisor in the maternity department of 
the hospital until 1941. She was a general 
duty nurse there until 1942, when she 
joined the Royal Canadian Army Medical 
Corps. 

She served as a lieutenant nursing 
sister in army hospitals in the Pacific 
Command and on the Canadian hospital 
ship Lady Nelson. She went overseas as 
captain (assistant) matron with the No. 
24 Canadian General Hospital. Following 
service in England, she served in Italy and 
Holland. Mrs. McIIrath served with the 




GlennisN. Zilm, assistant editor of 
THE CANADIAN NURSE since October 1964, 
left the staff at the end of January. She 
plans to do free-lance writing while she 
completes her final year of journalism at 
Carleton University this Spring. After 
that Miss Zilm's plans are uncertain, but 
she will be on hand to help the Canadian 
Nurses' Association's public relations 
team at the ICN Congress in June 1969. 

A 1958 graduate of the combined 
nursing program at The Vancouver Gener- 
al Hospital and the University of British 
Columbia, Miss Zilm had considerable ex- 
perience in nursing before joining the 
journal staff. Her experience included 
nursing administration in a small hospital 
in British Columbia, public health nursing 
in the School Health Service in Sydney, 
Australia, and clinical instruction at the 
Royal Columbian Hospital in New West- 
minster. 

Miss Zilm has become well-known to 
many Canadian nurses during her four 
years as assistant editor. In both 1967 
and 1968 she visited hospitals and public 
health agencies in all the Western 
provinces to explain the policies of 
THE CANADIAN NURSE and to encourage 
nurses to write articles for their national 
magazine. She gained many friends for 

THE CANADIAN NURSE 21 



names 




the journal during these visits, and was 
responsible for obtaining much inter- 
esting material for journal readers. 

As a direct result of Miss Zilm's 
eagerness to obtain new information and 
to pass it on to other nurses, the "Idea 
Exchange" pages were born. Her cre- 
ativity has been shown in many other 
ways, not the least of which are the 
"News" pages, the department that has 
become the most popular among readers. 
In addition. Miss Zilm has written many 
well-researched articles for the journal, 
one of which appears in this month's 
issue (p. 37). 

The staff of the Canadian nurse 
and L'injirmiere canadieivie, as well as 
the readers of these magazines, will miss 
Glennis Zilm. We wish her well in her 
journalism career, wherever it may lead. 

-V.A.L. 
Several new staff 
members have joined 
the faculty of the 
school of nursing at 
j^^— The University of 
'1*^^ Alberta. 

Alice R. MacKin- 
non (R.N., U. Alber- 
ta H., Edmonton; 
B.Sc, U. Alberta. 
M.N., U. Washington, Seattle) has been 
appointed assistant professor. 

A native Albertan, Mrs. MacKinnon 
spent six years in the United States and 
Canada in public health nursing, edu- 
cation, and supervision. She returned to 
Edmonton to become principal of the 
School for Nursing Aides, a position she 
held for five years. During the next five 
years, she was associate director of nurs- 
ing education at the school of nursing. 
Foothills Provincial General Hospital, Cal- 
gary. She is currently teaching nursing 
education in the postbasic degree, basic 
degree, and diploma programs. 
^ Margaret Ann 

Beswetherick (R.N., 
Vancouver General; 
Dipl. Teaching & 
Superv., U. British 
Columbia; B.N., 
M.Sc, McGill U.) 
has been appointed 
assistant professor. 
Miss Beswether- 
ick began her career as a general duty 
nurse at The Vancouver General Hospital, 
following it with experience in a small 
hospital. After completing the diploma 
program in clinical supervision at the Uni- 
versity of British Columbia, she became a 
member of the teaching staff of The Van- 
couver General Hospital for six years. She 
then attended McGill University, first to 
attain a bachelor of nursing degree in 
22 THE CANADIAN NURSE 




administration in hospitals and schools of 
nursing and later to obtain a master of 
science degree in nursing education and 
administration. She then served as asso- 
ciate director of nursing education at 
Kingston General Hospital for two years, 
leaving this to become nursing advisor to 
the Registered Nurses' Association of 
Nova Scotia. While in Nova Scotia, she 
served also as a consultant on nursing 
service for the Nova Scotia Hospital In- 
surance Commission. 

She is currently teaching nursing ad- 
ministration. 

Gloria C. Gehlert (R.N., U. Alberta H., 
Edmonton; B.Sc, U. Alberta) has been 
appointed lecturer. 

After graduation, Mrs. Gehlert spent 
two years in Hawaii as a general duty 
nurse, returning to Alberta to take a 
public health nursing position with the 
City of Edmonton Health Department for 
two years. Following this, she served for a 
three-year period as a clinical instructor 
in medical-surgical nursing at the Uni- 
versity Hospital, Edmonton and subse- 
quently completed the postgraduate 
course in cardiology nursing there. She is 
presently teaching in the four-year basic 
degree program in the advanced medical- 
surgical area. 

Sandra Arleigh 
Shanks MacDonald 
(R.N., Victoria 
Public H., Freder- 
icton; B.N., Dipl. 
Teaching & Superv., 
Dalhousie U.) has 
been appointed 
— J J^^ lecturer. 
m jS^M Mrs. MacDonald 
has graduate nursing experience in both 
operating room and emergency de- 
partments in hospitals in the Maritimes. 
She is presently teaching in the basic 
degree program in the advanced medical- 
surgical area. 

Marjorie Sandilands (R.N., U. Alberta 
H., Edmonton; B.Sc, U. Alberta) has 
been appointed lecturer. Following ex- 
perience as instructor in pediatric nursing 
at the University Hospital, Edmonton, 
she is currently teaching maternal and 
child health and junior medical-surgical 
nursing in the basic degree program. 

L e i th Nance 
(R.N., Alberta H., 
Ponoka ; B .N., 
McGill U.) has join- 
ed the faculty as 
lecturer in psychia- 
tric nursing jxi the 
four-year basic 
degree program. 
Prior to completing 
her degree at McGill, Miss Nance spent 
several years in general duty and teaching 
in Alberta, Hawaii, and Australia. Follow- 
ing this, she served as an instructor in 
psychiatric nursing at The Montreal Gen- 
eral Hospital, leaving to join the World 







Health Organization with postings in 
Egypt and Burma. 

Rene Oberholtzer 
(R.N., U. Alberta H., 
Edmonton; B.Sc, U. 
Alberta) has been 
appointed lecturer. 
Following experi- 
ence in public health 
nursing with the 
city of Calgary 
Health Department, 
Mrs. Oberholtzer returned to the univer- 
sity to teach fundamentals and senior 
medical-surgical nursing in the basic 
degree program. 

Frances Murphy 
(R.N., St. Paul's H., 
Vancouver; B.ScN., 
U. British Columbia) 
has joined the staff 
as lecturer in psy- 
chiatric nursing in 
the basic four-year 
degree program. 
Following general 
duty experience at St. Mary's Hospital in 
New Westminster, B.C., Miss Murphy held 
public health nursing positions with the 
Metropolitan Health Committee in Rich- 
mond, B.C. and with the Calgary Health 
Department. She leaves her position as 
clinical instructor in psychiatric nursing 
at the Royal Inland Hospital, Kamloops. 
Joyce Sharpe (R.N., U. Alberta H., 
Edmonton; B.Sc, U. Alberta) has joined 
the faculty as sessional demonstrator. 

Following two years of public health 
nursing in Alberta with the Sturgeon 
Health Unit, Mrs. Sharpe is presently con- 
cerned with the planning and supervision 
of public health nursing experience and 
related duties with the on-campus well 
child chnic for families of students at- 
tending the University of Alberta. 

Carol Lynn McWilliam (B.N., U. New 
Brunswick) has been named clinical in- 
structor at the University of New Bruns- 
wick School of Nursing. Mrs. McWilliam 
was formerly employed as a staff nurse at 
Victoria Public Hospital in Fredericton. 

Doris D.N. Stevenson (R.N., Calgary 
General; B.Sc, U. Alberta; M.N., U. 
Washington, Seattle) has replaced Sister 
Marguerite Letourneau as director of 
nursing education at Holy Cross Hospital 
in Calgary. 

Mrs. Stevenson was formerly assistant 
director of nursing at Rockyview Hospital 
in Calgary. She also worked for seven 
years at Medicine Hat General Hospital, 
Alberta, as clinical instructor and super- 
visor, science instructor, and associate 
director of nursing education. She spent 
one year at Royal Alexandra Hospital in 
Edmonton as science instructor and at 
the University of Alberta Hospital in 
Edmonton as a general duty nurse. 

(contimied on page 24) 

FEBRUARY 1969 




New 2nd Edition! 
Lerch 



ADD 
NEW DIMENSION 

TO TOTAL 
PATIENT CARE 



A New Text! 
Kaluger-Unkovic 

PSYCHOLOGY and SOCIOLOGY 

An Integrated Approach to 
Understanding Human Behavior 

Here is the first nursing-oriented text which fully integ- 
rates psychology and sociology to give the student a more 
complete understanding of her role in total patient care. 
Through a careful integration of these two important dis- 
ciplines, this new text helps the student effec- 
tively develop a frame of reference for under- 
standing the total person. To do this in the 
most effective manner, a straight text presen- 
tation of principles has been combined wnth a 
unique case study approach. Actual case histo- 
ries are developed around physiologic, psycho- 
logic and sociologic elements to show real peo- 
ple with medical problems. They are presented 
in a medical context and related to an institutional 
setting. These case materials are conveniently located 
at the end of the text but can be utilized at any point 
you prefer. A complimentary test manual and teacher's 
guide is provided instructors adopting this text. 

By GEORGE KALUGER, Ph.D., Professor of Psychology and 
Education, Shippensburg State College, Shippensburg Pa • and 
CHARLES M. UNKOVIC, Ph.D.. Chairman and Professor of 
Sociology, Florida Technological University, Orlando, Fla. Pub- 
lication date: April, 1969. Approx. 496 pages, 7"x 1 0", 42 il- 
lustrations. About $10.85. 



WORKBOOK FOR MATERNITY NURSING 



Add new meaning to your courses in "Obstetric and Maternity 
Nursing" with the aid of this extremely effective supplement 
to text, lecture and clinical experience. This carefully revised 
and updated new 2nd edition clearly reflects today's total 
patient care, psycho-social orientation in nursing. You will 
find new information to help the student correlate the parents' 
emotional fulfillment with the technical aspects of her duties: 
a new introductory unit dealing with such topics as biological, 



THE C. V. MOSBY COMPANY, LTD. 

86 Norlhlme Road • Toronto 16, Ontario 
FEBRUARY 1%9 



physiological and psychological aspects of pregnancy 
and parenthood; and an increased number of clinical 
problem-solving situations. Pages are perforated and 
punched, and a helpful answer book is provided all 
instructors adopting this workbook. 

By CONSTANCE LERCH, R.N., B.S.(Ed.). Philadelphia, Penn- 
sylvania. Publication date: April, 1969. 2nd edition, 303 
pages plus FM l-VIII, 7V4" x 1 0V2", 33 illustrations. Price, 
$5.40. 



M 



Publishers 



THE CANADIAN NURSE 23 



moving? 

married? 

wish an adjustment? 



All correspondence to THE CA- 
NADIAN NURSE should be ac- 
companied by your most recent 
address label or imprint (Attach 
in space provided.) 

Are you 

D Receiving duplicate copies? 
D Actively registered with more 

than one provincial nurses 

association? 



Permanent reg. no. 



Provincial association 



Provincial association 



Permanent reg. no. 

D Transferring registration from 
one provincial nurses' asso- 
ciation to another? 

From: 

Provincial association Permanent reg. no. 

To: 

Provincial association Permanent reg. no. 

Other adjustment requested: 



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ATTACH CURRENT LABEL 

or IMPRINT HERE to be 

assured of accurate, 

fast service 

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The Canadian Nurse cannot 
guarantee back copies unless 
change or interruption in de- 
livery is reported within six 
weeks! 
Address all inquiries to: 



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1 Oept-. 50 The Dfi 



(Continued from page 22) 

Frances May 
Moss (B.A., Dalhou- 
sie U.; R.N., Royal 
Victoria H., Mon- 
treal; Dipl. Teaching 
and Superv., Dipl. 
Admin., McGill U.) 
is the new executive 
secretary of the 
Registered Nurses' 
Association of Nova Scotia. Mrs Moss 
leaves a position she has held for the past 
13 years as instructor of medical-surgica^ 
nursing at MUlard Fillmore Hospital 
School of Nursing, Buffalo, New York. 

Mrs Moss worked at Victona General 
Hospital in Halifax for 13 years as as- 
sistant director and director of nurses. 
She also was an instructor at the Sydney 
City Hospital, Nova Scotia, and head 
nurse at Royal Victoria Hospital, Mon- 
treal. 

Laveena Anne 
^^^ Gittins (B.Sc.N., U. 

^^^R^ Saskatchewan) has 
^^P^M been appointed 
^^^ ^H coordinator of the 
CJ "^ jr school of diploma 

^_ nursing, Saskat- 

\ ^ chewan Institute of 

Applied Arts and 
Sciences. Mrs. 
Gittins has worked at Saskatoon City 
Hospital as a staff nurse and as an m- 
structor; at the Saskatchewan Institute ot 
Applied Arts and Sciences as instructor; 
and at Weyburn Union Hospital, Saskat- 
chewan as head nurse. 



The new director 
of the Algoma 
Regional School of 
Nursing in Sault Ste. 
Marie is E. Jean 
^ -^^ (^ Mackie (R.N., Royal 

^^^^^^^ Alexandra Hospital, 
^^^^^^^1 Edmonton; Cert. 
^^^■^^M Teaching Superv., U. 
•■^^^■^ Toronto; B.N., 
McGUl U.; M.N., U. Washington, Seatde). 
Miss Mackie was formerly chairman of 
the department of nursing education at 
Mount Royal Junior College, Calgary. 

Miss Mackie has devoted her nursing 
career to education. She was nursing arts 
teacher for five years at the Royal Alex- 
andra Hospital School of Nursing; clinical 
teacher at Calgary General Hospital for 
six years, and assistant director of nursing 
education for two; and medical-surgical 
nursing teacher at Everett Commumty 
College, Washington, for one year. D 




k=» ~ 



Next Month 



in 



The 

Canadian 
Nurse 



• Rare Blood Groupings 

• Today's Hospital 
and Infection Control 

• CNA Library Services 




Photo credits for 
February 1969 



Miller Services Ltd., Toronto, 
cover photo 

Crombie McNeUl Photography, 
Ottawa, p. 9 

Tootons Studios, 
St.John's,Nfld.,p. 14 

Roy Nicholls, Willowdale, 
Ont., p. 38 

Normalair, Yeovil, p.39 

Toronto General 
Hospital, p. 40 



FEBRUARY 19( 



24 THE CANADIAN NURSE 




February 10-13, 1%9 
March 20-23, 1%9 
April 14-17, 1%9 

Regional conferences on the use of 
audiovisual aids in nursing, sponsored 
by the Registered Nurses' Association 
of Ontario. To be held in Sudbury in 
February, Ottawa in March, and Fort 
William in April. Fee: RNAO mem- 
bers, $25; non-members, $35. Write 
to: RNAO, 33 Price St., Toronto 5. 

August 1968 - June 1%9 

The National League for Nursing is 
sponsoring a series of 12 two-day 
workshops in several U.S. cities for 
persons involved in administration, 
planning, and evaluation of hospital 
nursing services. The first workshop 
was held in San Francisco August 9, 
1968, and the last will be held in 
Miami Beach, June 26-27, 1969. 

The workshops are designed for 
nurses and others interested In nurs- 



ing audits, new staffing patterns, and 
hospital staff development programs. 
Further information and applica- 
tion forms for registration may be 
obtained from the Department of Hos- 
pital Nursing, National League for 
Nursing, 10 Columbus Circle, New 
York, New York 10019. 

February 11-12, 1969 
February 13-14, 1%9 

Workshops on "how to achieve better 
integration in the nursing program." 
First workshop to be held in Edmon- 
ton, second in Calgary. Conducted by 
Miss Dorothy Rowles, Ryerson Poly- 
technical Institute, Toronto. 

February 17-19, 1%9 

Second Canadian Conference on Hos- 
pital-Medical Staff Relations, Chateau 
Frontenac, Quebec City. Theme: Better 
communications for better patient 
care. Sponsored by Canadian Hospital 



Association, Canadian Medical Asso- 
ciation, and Canadian Nurses' Asso- 
ciation. 

February 24-27, 1969 

Association of Operating Room Nurses, 
16th annual meeting, Cincinnati, Ohio. 

March 3-28, 1%9 

Advanced program in health services 
organization and administration. 
School of Hygiene, University of To- 
ronto. Part two of course to be held 
in March 1970. For additional infor- 
mation and registration data write: 
Dr. R.D. Barron, Secretary, School of 
Hygiene, University of Toronto, To- 
ronto 5. 

March 10-12, 1%9 

15th annual combined meeting for 
doctors and nurses sponsored by the 
American College of Surgeons, Boston, 
Massachusetts. Further information is 
available from ACS, 55 East Erie St., 
Chicago, Illinois 60611. 

March 18-20, 1%9 

Institute on Administration for Hospi- 
tal Administrators and Directors of 
Nursing Service, conducted by Amer- 



PROFILE OFA MEMORIAL NURSE 



(( 



YOU'RE SURE TO FIND IT 



On Manhattans fashionable Fifth, the shops 
range from the "5 & 10" to the elegance of 
Sak's Fifth Avenue. You can shop to your 
heart's content at expanding Memorial, loo. 
You are needed now in Recovery, Research, 
Pediatrics, Intensive Care, Neurology & Neu- 
rosurgery, Clinical Specialities-Medical & 
Surgical Nursing." 

For the RN who wants to find her true self, 
call or write: MRS. BEATRICE A. CHASE, 
Director of Nursing. 




(212) 879-3000 



• HOUSING FACILITIES • TOP SALARIES • EXCELLENT BENEFITS 
• 4 WEEKS VACATION • MANY OTHER EXTRAS 

MEMORIAL HOSPITAL 

of MEMORIAL SIOAN-KEITERING CANCER CENTER 

444 East 68th Street, New York, N.Y. 10021 
An Equal Opportunity Employer 
■FEBRUARY 1%9 




THE CANADIAN NURSE 25 




icon Hospital Association. To be held 
at the American Hospital Association, 
840 North Lake Shore Drive, Chicago, 
Illinois 60611. Apply to above 
oddress. 

March 24-29, 1969 

Symposium on recovery room and in- 
tensive care nursing, Grace General 
Hospital, Winnipeg. Registration: $20. 



For further details; Miss J.W. Robert- 
son, Director - Inservice Education, 
Grace General Hospital, 300 Booth 
Dr., Winnipeg 12. 

April 13-17, 1969 

American Association of Neurosurgi- 
cal Nurses Meeting, Cleveland, Ohio. 
Information may be obtained from: 
Miss S.M. Sowchyn, 99 Fidler Ave., 
St. James 12, Manitoba. 

May 13-16, 1969 

Alberta Association of Registered 
Nurses, annual convention, Macdo- 




Second Conference 

Hospital - Medical Staff Relations 

16 to 19 February, 1969 

Chateau Frontenac, Quebec City 



Jointly Sponsored by: 

Canadian Hospital Association 
Canadian Nurses' Association 
Canadian Medical Association 

PROGRAM 

Participants are divided into four sections, each including: Trustees; 
Administrators; Medical Staff Representatives; Nursing Representatives. 
Each section is further divided into two types of groups: A — profes- 
sional; B — mixed. 



Sunday, 16 February 

Registration 

Meeting of Group Leaders 

Group Orientation — sectional 

Reception 

Monday, 17 February 

Registration 
Opening Ceremonies 
Keynote Speaker: Dr. E. W. 
Barootes, Regina, Sask., CMA 
Executive Committee member 
Meetings — sectional, A and B 



Tuesday, 18 February 

Meetings — sectional, A and B 

Reception 

Official Dinner 

Wednesday, 19 February 

Keynote Speaker: Dr. A. B. C. 
Powell, Medical Director, Work- 
men's Compensation Board of 
Ontario — "the Team Approach 
in the Hospital" 
Reports of Sections 
Summation 



Topics for discussion include: 

— purpose of the organization 

— process of delegation 

— creating opportunities to participate in decision-making 

— process of communications. 



nald Hotel, Edmonton, Alberta. 

April 14 - May 9, 1969 
May 12 - lune 6, 1969 

Rehabilitation Nursing Workshops, 
University of Toronto. Four-week 
course for R.N.s employed in acute 
general and chronic illness hospitals, 
nursing homes, public health agencies, 
and schools of nursing. Tuition fee: 
$150. Apply to: Division of University 
Extension, Business and Professional 
Courses, 84 Queen's Park, Toronto 5, 
Ont. 

May 19-23, 1%9 

National League for Nursing, 1969 
convention. To be held in Cobo Hall, 
Detroit, Michigan. Fee: NLN members, 
$15; non-members, $25. Write to: 
NLN, 10 Columbus Circle, New York, 
N.Y. 10019. 

May 21-23, 1969 

Registered Nurses' Association of Brit- 
ish Columbia, annual meeting. Bay- 
shore Inn, Vancouver. Write: RNABC. 
2130 W. 12th Ave., Vancouver 9. 

May 21-23, 1969 

Canadian Hospital Association, 2nc 
national convention. Civic Centre, Ot 
tawa. 

May 28-30, 1969 

The New Brunswick Association o\ 
Registered Nurses, annual meeting 
New Brunswick Hotel, Moncton. 

June 1-13, 1969 

Eighth annual residential summei 
course on alcohol and problems of ad- 
diction, Trent University, Peterbor- 
ough, Ont. Co-sponsored by Tren 
University and the Addiction Research 
Foundation, an agency of the province 
of Ontario. 

June 16-18, 1969 

Conference on nursing education foi 
visitors to the International Council o1 
Nurses Quadrennial Congress. Spon- 
sored by the school of nursing one 
alumni association. University of To- 
ronto. June 19-20: tours in Torontc 
and environs to be arranged at re- 
quest of persons attending conference. 
Apply to the Secretary of the School, 
University of Toronto School of Nurs- 
ing, 50 St. George St., Toronto 5. 



June 22-28, 1969 




26 THE CANADIAN NURSE 



International Coun- 
cil of Nurses' Qua- 
drennial Congress, 
Montreal. Fee: be- 
fore Jan. 22, $40; 
after Jan. 22, $60. 
Write to: ICN Con- 
gress Registration, 
50 The Driveway, 
Ottawa 4, Ont. D 

FEBRUARY 196>^ 



new products 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




Hotchkiss Otoscope 

The Hotchkiss Otoscope is a new otos- 
copic system with coaxial lighting (the 
same principle as the headmirror), 
designed to improve and simplify ear ex- 
aminations and instrumentation. 

Designed by Dr. John E. Hotchkiss, a 
San Francisco otolaryngologist, the new 
system eliminates parallax error - a basic 
deficiency of standard otoscopic systems. 
It also provides up to four times brighter 
illumination than traditional otoscopes. 

The optical head weighs only 2-1/4 
ounces and measures 4-3/4 inches from 
the eye piece to the speculum tip. The 
instrument is designed to be held by the 
thumb and index finger of one hand leav- 
ing the mid-finger to straighten the canal 
and the other hand free for instru- 
mentation, positioning the patient's head 
forpneumoscopy. An improved speculum 
design permits instrumentation under full 
magnification and eases the pneumatic 
procedure. 

Other features of the instrument in- 
clude an around-the-neck power supply, a 
5x magnification unit, corrective lens for 
bifocal wearers, and completely dis- 
posable specula. In addition, by use of a 
photographic adaptor and single-lens 
reflex camera, the otoscope can be used 
for photography of the ear drum and 
nasal passages. 

FEBRUARY 1%9 



Additional information may be obtain- 
ed from "Smith Kline & French, Inter- 
American Corporation, 300 Laurentian 
Blvd., Montreal 379. 

New Canadian Allergy Service 

Winley-Morris Co. Ltd.. in conjunction 
with Purex Laboratories Inc., New York, 
announces the establishinent of a new 
Canadian Allergy Service under the Purex 
label. 

Available from Montreal stocks are 
testing kits, treatment solutions, and 
accessories for a complete allergy prac- 
tice. 

Prices and catalogues are available on 
request from Winley-Morris Ltd., 2795 
Bates Rd., Montreal 251. 

Bedside Toilet 

This electrically operated, recirculating 
flush toilet may be wheeled to the 
patient's bed. The Mobile Monomatic 
toilet eliminates patient stress and the 
psychological block often associated with 
bedpans and commodes. The toilet also 
substantially reduces nursing involvement 
with toilet duty and provides approved 
sanitation for areas that lack plumbing 
facilities, without costs of plumbing re- 
habilitation. 

Because of the unit's proprietary 
chemical, the toilet provides immediate 
bacteria and odor control and results in 
less annoyance to other patients in the 
area. 

For further information: Gerry Ste- 
vens Companies, 145 Wellington St., 
Toronto 1, Ont. 





Child-Resistant Pill Bottle 

This new child-resistant pill bottle, 
designed to prevent many of the acci- 
dental poisonings that occur every year, is 
marketed under the name "Palm-N- 
Turn." The new container consists of a 
polypropylene cap on a crystal poly- 
styrene vial. To open the container, you 
must press the cap into the palm of the 
hand and give the vial a quarter turn to 
the left. 

The pliable plastic cap has notches in 
it that fit over the lugs on the vial when 
the container is closed. You can pry it, 
twist it, or shake it, but it won't come 
off. By pressing it into the palm of your 
hand, however, a springy plastic disc 
inside the cap is depressed to release the 
notches from the lugs. A quarter turn 
then releases the cap completely. 

Even if a youngster learns the knack, 
he's unlikely to be able to use it because 
it takes about 12 pounds of pressure to 
depress the plastic spring. While this is 
very little effort for an adult, it is about 
three pounds more than a typical five- 
year-old can bring to bear. 

It is manufactured by Reflex Corpora- 
tion, Amhurstburg, Ont. 

Allergy Chart 

To help mothers avoid allergens more 

completely, Gerber Products Company 

THE CANADIAN NURSE 27 



new products 



(Continued from page 27) 
has prepared a chart listing the many 
Strained and Junior foods available for 
babies and indicating which, if any, of the 
four common allergens each food con- 
tains. Most food allergies among infants 
are caused by one of four common foods: 
milk, wheat, egg. and citrus fruit. Spot- 
ting the offender is usually fairly simple. 



and avoiding that food in its pure form is 
equally simple. These four foods, 
however, are also found as ingredients in 
many combination foods. 

With the chart handy, a mother can 
determine at a glance whether a particular 
food contains the food element to which 
her baby is allergic. The chart is coded 
with the letters M (Milk), W (Wheat), E 
(Egg) and C (Citrus Fruit), and also con- 
tains a listing of all gluten-free Gerber 
Baby Foods. 

Reprints of the chart are available 
from doctors or free on request from 





For nursing 
convenience... 

patient ease 

TUCKS 

offer an aid to healing, 
an aid to comfort 

Soothing, cooling TUCKS provide 
greater patient comfort, greater 
nursing convenience. TUCKS mean no 
fuss, no mess, no preparation, no 
trundling the surgical cart. Ready- 
prepared TUCKS can be kept by the 
patient's bedside for immediate appli- 
cation w^henever their soothing, healing 
properties are indicated. TUCKS allay 
the itch and pain of post-operative 
lesions, post-partum hemorrhoids, 
episiotomies, and many dermatological 
conditions. TUCKS save time. Promote 
healing. Offer soothing, cooling relief 
in both pre-and post-operative 
conditions. TUCKS are soft 
flannel pads soaked In witch hazel 
(50%) and glycerine (10%). 



TUCKS — the valuable nur- 
sing aid, the valuable patient 
comforter. 



\A/ \VINLEY-MORRIS>HV> 

AA MONTREAL CANADA 

TUCKS is a trademark of the Fuller Laboratories Inc. 



Gerber Products Company, Niagara Falls, 
Ontario. 

Surgical Drain 

This versatile new surgical drain 
features a triple-lumen construction that 
permits the drain to serve as an overflow, 
suction, and sump drain, depending upon 
the individual surgical requirement. 

It will be known as the Abramson 
Drain, named after its inventor, Daniel J. 
Abramson, M.D., F.A.C.S., of the Wash- 
ington Hospital Center, Washington, D.C. 

The triple-lumen drain is elliptical with 
a large central lumen of approximately 
1/4-inch I.D., and two companion tubes 
molded into the outer margins of the 
ellipse. The center lumen can be used for 
overflow, suction, drainage, or irrigation, 
or both tubes may be used for the same 
function. 

Therefore, depending upon how the 
three lumens are used, the Abramson 
drain fulfills many functions. 

The prospect of clogging is reported 
by Davol to be minimized by the triple 
lumen design and the large eyes on the 
distal tip. 

Indications for use of this drain are: 
clean surgical wounds in which excessive 
drainage or bleeding may occur, such as 
operations on the biliary tract, thyroid, 
or breast; potentially infected wounds 
such as occur in trauma or emergency in- 
testinal resections; established infections, 
as in peritoneal, pelvic, sub-hepatic or 
other abscesses. 

Made of soft, pliable, medical grade 
PVC, the Abramson Drain is available in 
surgically sterile, 1 8-inch lengths. 

Evaluation quantities are available to 
hospitals from Davol Inc., Providence, 
Rhode Island. 




28 THE CANADIAN NURSE 



642 Tablets 

642 tablets (propoxyphene HCl 65 
mg.) are indicated for the relief of moder- 
ate pain. They are of value in providing 
symptomatic relief for: muscle and joint 
pain, premenstrual and postpartum pain,, 
dysmenorrhea, pain associated with in- 
fection, postoperative pain, headaches, 
atid post traumatic pain. 

Orally administered, propoxyphene 
hydrochloride produces effective plasma 
levels within one hour, as evidenced by 
plasma experience. Less than 10 percent 
of the unchanged drug can be recovered 

FEBRUARY 1%9 



new products 



from urine collected over a 24-hour 
period. 

642 tablets are round, yellow, and 
film-coated, and are available in bottles of 
100 and 500 tablets. Full information 
may be obtained from: Charles E. Frosst 
& Co., P.O. Box 247, Montreal 3. 




Cytec 

Cytec is a modern method of sputum 
analysis for the detection of lung cancer 
in its most curable and easy-to-treat 
stages. 

The Cytec system consists of an elec- 
tronic computerized cyto-screening anal- 
yzer that can measure cell parameters and 
distinguish the difference between normal 
and abnormal cells, and a kit for the 
collection of early morning cough speci- 
mens. 

Modern bio-engineering techniques 
now permit optical scanning of free float- 
ing sputum cells at the rate of 200 per 
second for approximately 20,000 cells 
from a four-day specimen, as compared 
with only a few hundred cells possible by 
conventional methods. 

Significantly, these same optical scan- 
ning techniques permit accurate detection 
of the early biochemical changes in 
nucleus and cytoplasm known to occur in 
the premalignant cell, some 36 months 
prior to any radiological evidence. 

If used in mass screening of an entire 
population, the Cytec test can lead to 
significant reduction of the mortality rate 
in this disease. 

Senokot Syrup 

This pleasant tasting syrup is indicated 
for the effective correction of consti- 
pation. Each 5 ml. contains the equiva- 
lent of 2 ml. of Standardized Senna 
Syrup Concentrate standardized to an 
average value of 5 mg. Sennosides A and 
B per ml. 

Senokot Syrup is particularly accepta- 
ble to children and the elderly. It offers 

FEBRUARY 1%9 



the advantage of teaspoon, not table- 
spoon dosage. 

Further information is available from 
The Purdue Frederick Company (Canada) 
Ltd., 123 Sunrise Avenue, Toronto 16, 
Ont. 

Valium Injectable 

After four years of clinical investi- 
gations by over 200 Canadian phy- 
sicians, Hoffman-LaRoche Limited, 
Montreal, has released an injectable form 
of Valium, one of the most widely pre- 
scribed psychotropic drugs. Valium In- 



jectable is especially useful when rapid 
onset of action is required in acute anxie- 
ty or tension states related to stressful 
conditions. 

Each 2 cc. Valium ampoule contains 
10 mg. diazepam. It is indicated for the 
relief of anxiety states including those 
present before minor surgery and prior to 
esophagoscopy and gastroscopy; relief of 
muscle spasm in cerebral palsy and athe- 
tosis; and control of prolonged seizure 
activity in status epilepticus. 

For further information: Hoffmann-La 
Roche Limited, Montreal 9. D 



ASSISTOSCOPE 

DESIGNED WITH THE NURSE 
IN MIND 

Acoustical Perfection 



▲ SUM AND DAINTY 

▲ RUGGED AND DEPENDABLE 

▲ LIGHT AND FLEXIBLE 

A WHITE OR BLACK TUBING 

▲ PERSONAL STETHOSCOPE TO FIT 
YOUR POCKET AND POCKETBOOK 

Order from 



M 



WINLEY-MORRIS CO. LTD. 

Surgical Products Division 
MONTREAL 26 QUEBEC 





^ 



ASSISTOSCOPE 

DESIGNED WITH THE NURSE 
IN MIND 

Acoustical Perfection 

A SLIM AND DAINn 

A RUGGED AND DEPENDABLE 

A LIGHT AND FLEXIBLE 

A WHITE OR BLACK TUBING 

A nrsohal sUTHOScopi ro fir 
voun POCKii ANo PoaaeooK 




WINLEY-MORRIS CO. LTD 

2795 BATES RD. MONTREAL, P.O. 

Please accept my order for 

'Assistoscope(s)' at $12,95 each 

□ White tubing Q Black tubing 



NAME - 



ADDRESS 



Residents of Quebec add 8% Provincial 
Tax. 



.J 

ales 



Made in Canada 



THE CANADIAN NURSE 29 



in a capsule 



Canadian quirks 

Who says you can't tell a Maritimer 
from a British Columbian? Or an Ontar- 
ian from a Newfoundlander? Or that les 
Quebecois have succumbed to English- 
Canadian habits? According to Marketing 
magazine, advertisers have doUars-and- 
cents evidence that we're all individual - 
in our eating habits at least. 

Take potato chips, for instance. 
Quebeckers consume by far the most 
potato chips of any of their compatriots 
in the other nine provinces. Toronton- 
ians, however, are more economy minded 
when they buy potato chips; 59-cent- 
and-up bags capture 75 percent of the 
Toronto market. In the less affluent 
Maritimes, however, five-and ten-cent 
bags corner the market. 

Easterners appear to like their coffee 
quick and easy whereas Westerners prefer 
to wait awhile to savor theirs. Much more 
instant coffee is sold in the eastern 
provinces; Westerners not only prefer the 
ground variety, but drink it much 
stronger than do Easterners. 

Quebec, though, has the most individ- 
ual eating habits of all 10 provinces. 
Manufacturers claim that in other parts of 
Canada they couldn't give away the 
spruce beer that is a bestseller in Quebec. 
Quebec also is the largest per capita soft 
drink market in the world. And Quebec- 



kers don't restrict their buying to spruce 
beer, ginger ale, or colas; they drink 
everything from cream soda to lemon- 
lime. 

Les Quebecois consume 80 times as 
much molasses as other Canadians. They 
eat two olives to an Ontarian's one. They 
buy more expensive cuts of meat than 
their richer Ontario neighbors. They turn 
up their noses at the quick dinners in a 
can — such as chili con came and weiners 
and beans — that other Canadian house- 
wives couldn't do without. And despite 
their larger families, they prefer their 
fruit juices in 20-ounce to 48-ounce tins. 

The key to success on the Quebec 
market, according to one food marketer 
quoted in Marketing, is "make it sweet, 
make it red and make it chocolate. And 
you've got it made." 

In any case, there's no such thing as a 
national food market in Canada. "It's a 
whole lot of smaller markets, each one 
with its own peculiarities in different 
product categories," says a food market- 
ing expert. 

You couldn't look that one up in your 
Funk and Wagnalls. 

Beautiful nurses 

Nurses are renowned for their beauty 
all over the world and Canadian nurses 
are no exception. It was Canadian nurses. 




30 THE CANADIAN NURSE 



after all, who established the image of Air 
Canada's gorgeous hostesses. You may 
recall as well that last year's Miss Canada 
was a student nurse. And now, a Cana- 
dian nurse has been chosen by Breck Inc. 
to be a "Breck girl." 

You're probably familiar with the 
head-and-shoulder pastel portraits that 
appear in popular magazines to advertise 
Breck shampoos. At a recent symposium 
of operating room supervisors held in 
Niagara Falls, representatives from John 
H. Breck, Inc. chose blonde Virginia 
Gardhouse, an operating room supervisor 
at Queensway Memorial Hospital in Etob- 
icoke, Ontario to pose as a Breck girl. 

Miss Gardhouse will receive a pastel 
portrait of herself and have the added 
thrill of seeing her portrait in magazines 
all over North America. 

Cold type 

Did you wonder whether you needed 
new glasses after reading last month's 
THE CANADIAN NURSE ? Our priutcr IS uslng 
a new kind of type, called cold type, 
which is set by an IBM machine. The 
January issue was the trial run for this 
type and there were a few problems. 

For one thing, the type was rather 
small. We hope that the larger type you 
are now reading will be easier on the eyes. 
Another slipup was in the bold type 
headings, some of which were misprinted. 
For instance, did you notice the "new 
desing" featured in the Idea Exchange? 

We hope that these wrongs have been 
righted in this issue. 

Back to nature 

From time to time we receive unusual 
requests for use of space in this magazine 
but the most unusual of all was surely 
this: a "naturist-nudist" camp wishing to 
advertise in the canadun nurse and run 
"one and many repeats." 

Nurses would be naturals for member- 
ship in this camp, the management believ- 
ed, because they have such a lot of 
responsibility and are on their feet day 
and night. They could find "real re- 
laxation in our camp." A bonus for nurse 
members would be building up their body 
resistance against many possibilities of 
infections. 

We never did receive the actual copy 
for this advertisement, but we must admit 
that we were curious about what aspects 
of life in the camp it might illustrate! D 



FEBRUARY 1969 



We want 
a special kind 



of nurse* 



We want a nurse who can handle 
two jobs: one who can nurse the 
men of the Canadian Armed 
Forces and who can accept the 
responsibihties of being a com- 
missioned officer. That's why 
we're offering a salary of more 
than $590.00 a month. It's inter- 
esting work. You could travel to 
bases all across Canada and be 
employed in one of several 
different hospitals. 

It's challenging.You'll never find 
yourself in a dull routine. And, in 
addition, you have the extra pres- 
tige of being made a commis- 
sioned officer when you join us. 
If the idea intrigues 
you, you're probably 
the kind of special 
person we're looking 
for. We'd like to have 

you with us. 
Write: The Director of 
Recruiting, Canadian 
Forces Headquarters, 
Ottawa 4, Ontario. 




GO WITH US! THE CANADIAN ARMED FORCES 



VB04t3 



:BRUARY 1%9 THE CANADIAN NURSE 31 



when traumatic pain 
stops the action- 
stop the pain with 

PONSTAN 

(mefenamic acid, Parke-Davis) 

A DISTINCTLY DIFFERENT ANALGESIC 

■ non-narcoticH single chemical entity ■ oral administration 
■ well tolerated ■ demonstrated effectiveness* 

•In a controlled study of 920 patients with pain of varied etiology, including 

muscular aches, sprain, backache, dysmenorrhea, toothache, and bursitis, 

relief of pain after only one dose of PONSTAN was reported as good to 

excellent in 85% of the patients. 
indications: Relief of pain in acute and chronic conditions 
ordinarily not requiring the use of narcotics. 
DOSAGE AND ADMINISTRATION: Adults and adolescents over 14 years of age— 
500 mg. (2 capsules) as an initial dose, followed by 250 mg. (1 capsule) 
every six hours as needed. The major portion of clinical experience with 

PONSTAN has varied from single doses to 84 days of therapy. 
contraindications: Intestinal ulceration; diarrhea as a result of taking the 
drug; safe use in pregnancy not established; in children under 14 years 
of age until pediatric dose has been established. 
precautions: Administer with caution to patients with abnormal renal 
function, inflammatory diseases of the gastrointestinal tract, or those on 
anticoagulant therapy. Discontinue if diarrhea or rash occurs. 
SIDE effects: Mild and infrequent at doses up to 1500 mg. per day; 
dose-related, being more frequent with higher doses. Most frequently 
reported: drowsiness, dizziness, nervousness, 
nausea, diarrhea, G.i. discomfort, vomiting. 

FOR DETAILED INFORMATION ON PRECAUTIONS 

AND SIDE EFFECTS SEE PRODUCT BROCHURE 

AVAILABLE ON REQUEST. 

supply: Kapseals® of 250 mg. in 
bottles of 100 and 500. 



PARKE-DAVIS 



PASKE. DAVIS a COMPANY. LTD 



MONTRgAL 9 
CP-3S7Ga 



i(>. '. 




^¥C 



^^.-■iite 



E'^. 






.A\ 



^^V. 
^ 






w R t «. Cr 



Epidermolysis bullosa 



The story of two children who, with considerable care and support, have learned 
to cope with a rare, chronic, hereditary skin disease. 



Emily Melnyk 



The skin you are born with is yours 
for life - however long that may be. It is 
more than a protective covering - it is an 
organ ranking in importance with the 
brain, the heart, and the lungs. Your skin, 
because it is with you from the beginning, 
is peculiarly your own, even more than 
your personality. No other person's is 
quite like it An example of this unique- 
ness is your fingerprint pattern that never 
duplicates that of anyone else. 

But nature can play tricks with the 
oackaging of our bodies, as the histories 
of the following two children with a rare 
disease called "epidermolysis bullosa" 
show. When Christ said, "Suffer little 
children to come unto me," He must 
surely have had in mind little ones such as 
Stephen and Marie, for their climb along 
life's highway is indeed frightening and 
hazardous. 

"Are these burn cases? " ask student 
nurses and visitors to Bloorview ChUdrens 
Hospital after seeing two of our patients, 
Marie and Stephen. 

On hearing the medical terminology 
for the condition "epidermolysis bullo- 
sa," most people remark that this is a 
mouthful; after an explanation of the 
treatment and nursing care involved, all 
comment that this is also a handful! 

Epidermolysis bullosa is an uncom- 
mon, chronic, hereditary disease of the 
skin, exhibiting several clinical forms and 
characterized by the development of 
sub-epidermal bullae following slight 
friction or trauma. These bullae contain a 
fluid that is usually serous but quite often 
hemorrhagic or purulent. They tend to 
FEBRUARY 1%9 



enlarge with pressure and eventually 
break down into painful, shallow denuda- 
tions which, on healing, leave scars. 

First observed by Dr. Von Hebra in 
1870 and described by Dr. T. Fox in 1879, 
epidermolysis bullosa received its present 
name from Dr. Koebner in 1886. In most 
countries, the name commonly used for 
this condition is chronic pemphigus. 

Currently, it is classified into four 
basic types: 

1. Simplex: This type accounts for 45 
percent of all cases. It is self-limiting, 
non-scarring and inherited by Mendelian 
dominant trait. Bullae, containing clear 
fluid, appear on the hands and feet. They 
generally heal without scarring and tend 
to decrease in severity as a patient grows 
older. There may be transitory pigmen- 
tation associated with the healing. The 
mucosal epitheUum is rarely involved. 
Patients have a normal span of life. 

2. Hyperplastic Dystrophic: Approxi- 
mately 30 percent of patients with chronic 
pemphigus fall within this classification. 
It is transmitted by a single autosomal 
recessive gene. Onset may occur at any 
time from birth to maturity. The mucosal 
epithelium is involved in about 20 per- 
cent of the cases. Bullae result from 
minor trauma to the skin, and contain 
either clear or hemonhagic fluid. Healing 

Mrs. Melnyk, a graduate of University School of 
Nursing, Graz, Austria, is Assistant Director of 
Nursing Education at the Bloorview ChUdrens 
Hospital in Toronto. She expresses her appre- 
ciation to Dr. Otto Weininger, psychologist, and 
the nursing staff at Bloorview Childrens Hos- 
pital, for their help in preparing this article. 



is accompanied by scarring. White 
papules, one to two mm. in diameter, 
frequently appear due to involvement of 
the sebaceous ducts. 

3. Hypoplastic Dystrophic: This clas- 
sification accounts for 25 percent of all 
cases and is also transmitted by a single, 
autosomal recessive gene. According to 
well-known dermatologists, there are six 
patients in Canada with this type. The 
onset is at birth; the newborn baby's skin 
may have a few sub-epidermal bullae at 
the time of delivery. These increase in 
size during the first few days of life. 
Widespread bullae develop following very 
minor trauma, and affect both skin and 
mucosa. They heal with extensive scar- 
ring. The skin becomes thick and xero- 
dermic in appearance; nails are deformed 
or absent; teeth are hypoplastic with 
extensive early cavities. The eyes, respir- 
atory tract, esophagus, anus, and vagina 
may be affected. Contractures, disappear- 
ance of the distal portions of digits, and 
total encasement of the hands in scar 
tissue have been known to follow. 

In severe cases, dwarfism (cachexia) is 
manifested. Marie is a good example of 
this aspect. In the past, many in this 
category died before reaching maturity. 
However, because of lack of research 
evidence it is hard to determine (due to 
the rarity of the disease, the short lives of 
those afflicted, and thus the lack of 
opportunity for extensive research) if this 
were due to the primary condition or to 
secondary infection and loss of blood. 
New concepts of treatment involving the 
use of steroids, and advances in plastic 
surgery promise a better prognosis for the 

THE CANADIAN NURSE 33 




^ 



Marie, aged 14, was admitted to Bloor- 
view Childrens Hospital in Toronto 
with epidermolysis bullosa when she 
was two years and three months old. 

future. 

Both Stephen and Marie have all the 
characteristics described in this type of 
epidermolysis bullosa. The intelligence 
quotient of both our little patients (75 to 
80 - low average) is a coincidence. It is 
not one of the characteristics of the 
condition. 

4. Letalis: This type is very rare. 
Infants die after a few weeks. 

Etiology 

Epidermolysis bullosa is caused by a 
genetic defect and represents some type 
of biochemical imbalance, presently 
unknown. The epidermis is frequently 
separated from the corium of the skin 
and in the dystrophic type involving 
mucosal epithelium it separates from the 
underlying tunica propria. Researchers 
have hypothesized that the underlying 
cause is a vascular defect, deficient elastic 
tissue, or dysfunction of the hyaluroni- 
dase hyaluronic acid system. 

During the early 1 950's, patients were 
treated in various ways. In 1952, Dr. 
Langhof used an ointment containing 
heparin to prevent blistering. Deficiency 
of heparin was considered responsible for 
imperfect hyaluronidase metabolism. In 
1957 Dr. Dorn treated two families with 
heparin and ephedrine hydrochloride. In 
34 THE CANADIAN NURSE 



that same period early reports concerning 
ACTH treatment were disappointing. 

At the present time, the beneficial 
results achieved with corticosteroids are 
thought to be due to two independent 
effects: 1. control of the inflammatory 
process and reduction in tissue damaged; 
and 2. restoration of the normal adhesive 
mechanism of the epidermal cells and 
prevention of blood loss. 

In March 1967, G.L. Severin described 
the management of epidermolysis bullosa 
in children with topical application of 
steroids — 0.2 percent fluocinolone aceto- 
nide cream. 

Treatment 

These little patients need an intensive 
program of regular supportive care. The 
objectives are: 

• To prevent bullae formation. 

• To prevent the spread of established 
bullae. 

• To prevent secondary infection and 
expedite healing. 

• To prevent contractures. 

The following measures are helpful in 
attempting to attain these objectives: 

• Bedding should be of soft, smooth 
materials. Infrequent handling of the 
patient as well as careful feeding are 
advisable. For instance, hot, pureed 
food should not be given. Physical stress 
and trauma must also be avoided. 

• Incision of bullae, or careful removal of 
four to six mm. of tissue, is performed 
to decompress tense lesions and prevent 
spread of infection. 



• Bathing with an antibacterial cleansing 
agent and application of antibiotic 
ointment help to protect the denuded 
areas. 

• Passive range of motion exercises, as 
tolerated, are beneficial. 

At Bloorview Childrens Hospital, only 
the supportive type of treatment is used 
at present. With advanced techniques in 
plastic surgery, surgical reconstruction of 
the hands may be anticipated in the 
future. 

Stephen 

Stephen, aged 9 years and five months, 
has been a patient at Bloorview Childrens 
Hospital for just over two years. He is an 
only child. A report from the Ontario 
Society for Crippled Children's district 
nurse states, "Stephen's mother seems to 
have had an excellent understanding of 
the child's illness and her attitude toward 
his disability is very understanding. When 
Stephen was at home she did his dressings 
several times daily, and was able to carry 
out the doctor's orders." 

Stephen's treatment and medications, 
as will be seen from the following outline, 
are intended to promote general physical 
well-being to the greatest extent possible, 
and to protect his fragile body from the 
added burden of superimposed infection. 
Chlor-triplon Syrup I tsp. t.i.d. with each meal 
Winstrol 2 mg. b.i.d. 
Orbenin 125 mg. q.6 h. 
Prednisone 5 mg. t.i.d. 
Poly-vi-sol 0.6 cc. o.d. 
Nupercainal ung. to relieve pain from lesions 




"One more dressing and I am ready to hug you, "Marie said 



after her daily 
FEBR 



dressing. 
UARY 1969 




In epidermolysis bullosa, bullae develop following minor trauma and affect both 
skin and mucosa. They heal with extensive scarring. 

nique is not necessary, but surgical clean- 
liness and loving patience on the part of 
the nurses who care for Stephen are 
required. 

The soft tulle gauze is lifted with the 
forceps and placed on a clean working 
surface. A minimum amount of Triburon 
Creme is applied with a spatula and the 
gauze is then applied to the area. This is 
repeated until all denuded areas and 
blisters have been covered. 

Stephen's arms are dressed first and 
then a tubular stockinette sleeve is pulled 
on gently to hold the gauze in place. A 
specially-made flannel vest joins at the 
shoulders with the arm stockinette, and 
effectively secures the dressings on his 
back and chest. 

His legs are dressed in the same 
manner as his arms. However, part of the 
stockinette covering his foot is doubled 
over to form a sock. Stephen wears a 
minimum amount of clothing. Small 
pieces of perforated Saran Wrap are 
put over his elbows and knees when he 
attends school to protect his books and 
school materials from becoming oily. 

Stephen is handled as little as possible 
throughout this part of his care. Other 
than lying down once for his leg dres- 
sings, he sits up for the entire procedure. 

When his dressings are completed, 
Stephen receives his nose and eye drops. 
Mouth care is given after each meal and at 
bedtime. 

Physiotherapy for this little boy con- 
sists of breathing exercises and gentle 
passive movement of his extremities to 
prevent contractures. Occupational thera- 
pists teach him how to perform various 
activities of daily living, for example 
dressing himself - he is now able to put 
on his own shirt - and encourage him to 
be as independent as possible. He is also 
learning to type, using his four unaffected 
fingers and his wrists. 

Stephen is co-editor of Bloorview's 
Morning Glory, a newspaper containing 
articles about the hospital written by the 



Neosporin ear and eye drops q.i.d. 

Metamucil h.s. or mineral oil, occasionally 

3 percent hydrogen peroxide diluted to 

1/2 strength and used t.i.d. as mouth wash 

Fer-in-sol 1 cc. t.i.d. 

Dressings of Triburon Creme once a day, 

or as necessary 

High protein diet using baby foods 

Weekly urinalysis 

Hemoglobin estimation as necessary 

Alpha-Keri in bath 

Stephen starts his day at 7:00 a.m. 
While still in bed, he begins to remove his 
dressings — this usually takes him about 
half an hour. He prefers to do this by 
himself because, as he explained, he is 
afraid of the pain that might occur should 
a staff member remove a dressing too 
suddenly. Every second day he has a 
warm tub bath to which has been added 
Alpha-Keri oil and Phisohex. Usually he 
stays in his bath for at least 20 minutes, 
enjoying it while his hair is washed with 
Nivea Creme shampoo. During the 
shampoo, his head is held in a backward 
position to prevent soap from getting into 
his eyes. 

Unfortunately, even though he enjoys 
his bath, he cannot be bathed daily 
because his lesions become jelly-like and 
do not dry as quickly. His dressings, 
however, are changed at least once a day 
or more often, if necessary. 

After his bath, Stephen is lifted out of 
the tub to the dressing table, a piece of 
Saran Wrap is placed beneath his but- 
tocks, and he is left to dry for a few 
minutes. 

Stephen's nurse makes sure that the 
supplies she needs to complete his care 
are on the dressing trolley. This includes 
two stainless steel pans, 6" x 4", contain- 
ing autoclaved squares of soft tulle gauze 
covered with Petroleum Jelly. Another 
small container, filled with alcohol, holds 
hfting forceps and scissors. Triburon 
Creme, spatulas, and other treatment 
materials are also available. Sterile tech- 
FEBRUARY 1969 



children. He has a keen sense of humor 
and is the source of most of the funny 
tales that are published. 

Stephen is very active, pushing himself 
around in his wheelchair and in general 
maintaining a very independent attitude. 
Since his physical condition does not 
permit him to reach for objects or to 
push buttons for elevators, he uses a 
specially-designed small rod that he 
carries about constantly. This permits 
him to overcome some of his limitations 
in school. 

He is progressing moderately well in 
school. His teacher says that he "works 
very conscientiously" and that he "has 
completed all of his work with very good 
results." He has successfully met the 
requirements for grade three work in 
reading, spelling, and arithmetic and is 
now progressing into grade four. Stephen 
enjoys school and its many challenges. 

Two weeks after his admission to 
Bloorview, Stephen was seen by a phychol- 
ogist. The results of tests carried out 
then indicated that he was functioning 
within the low average intellectual range. 
There has been no significant change in 
this level. 

According to the psychologist's assess- 
ment, Stephen is constantly striving to 
maintain control over feelings of hostility 
or aggression: "The particular way in 
which he seems to maintain this control is 
by trying to figure out what exists within 
the particular situation that is either 
threatening or potentially harmful to 
him." Thus, when confronted with spe- 
cific situations, Stephen views them as 
threatening to himself and tends to react 
to each one in similar, if not identical, 
ways. 

The particular kind of harm that he is 
most concerned with at this point is 
physical danger that might exacerbate his 
skin condition. He even feels that any 
expression of anger on his part is poten- 
tially damaging to his skin, since it might 
excite others to become angry with him 
and to harm him physically. Certainly 
there are times when he feels angry, but 
he controls any expression of this fairly 
well. Stephen also tries to deal with other 
small aspects of his existence through 
meticulous attention to minute detail. 
This serves to suppress impulsive action 
and hostility. 

According to the psychologist, "The 
general emotional patterning is one where 
feelings and impulses to aggression are 
strong, but are most unacceptable and 
their direct expression is severely repres- 
sed." Stephen's reaction is seen as inter- 
nalized aggression with a proneness to 
indiscriminate perception of and response 
to frustration with passive feelings, denial 
of aggression, and overly amenable, 
socially nice behavior. 

He tries hard to be pleasant and to 
have a smiling face at all times. As a 
result, it becomes extremely difficult to 

THE CANADIAN NURSE 35 



have him talk freely about his real feel- 
ings. The Projective Psychological Tests 
indicated that his anxiety level is high and 
that most situations present difficulties 
for him. This anxiety must be seen in 
relationship to Stephen's inability to cope 
with the external world, through fear that 
it will harm him. In a way, he is being 
realistic, but since he does not really test 
his world to find out what its advantages 
or disadvantages are, he remains in a kind 
of cocoon whereby real feelings are 
denied or inhibited by rigid intellectual 
processes or by complusive attention to 
small detail. 

Stephen's reaction to mental stress is 
poor. He has little emotional energy with 
which to respond to stressful situations. 
His usual response is to withdraw, feeling 
that he has done something wrong. This 
pattern of feeling angry with himself 
becomes most marked when he is under 
any kind of real emotional stress. 

There has been marked improvement 
in his relationships with other children - 
he is learning to share toys, records and 
books. He has a few favorites among the 
nursing staff to whom he tells a few of his 
"secrets." 

Marie 

And now let us meet Marie, aged 14, 
who has really never known any other 
home than Bloorview Childrens Hospital. 
She was admitted when she was only two 
years and 3 months old. 

Marie is small for her age. Physically, 
she resembles a child of approximately 6 
years. However, she refuses to be unduly 
limited either by her size or her physical 
illness. She pushes herself around in her 
wheelchair; she feeds herself; she writes, 
using protective coverings for her hands. 

Her medications and treatment are 
very similar to Stephen's: 

Meticortone 2.5 mg. t.i.d. 

Lederplex liquid 1/2 tsp. t.i.d. 

Fer-in-sol 1.2 cc. t.i.d. 

Poly-vi-sol 0.6 cc. o.d. 

Metamucil h.s. - mineral oU occasionally 

Petroleum Jelly dressings to body o.d. 

Alpha-Keri oil and mild soap for bath 

Cortef ung. to open lesions 

Soft or pureed diet - she is unable to chew 

or masticate food well 

High protein, carbohydrate, and fat diet 

Weekly urinalysis 

Frequent hemoglobin estimations 

Marie's dressing procedure is similar to 
Stephen's except that Petroleum Jelly is 
used instead of Triburon Creme. Her 
physiotherapy consists of gently passive 
extension of wrists, elbows, and knees, 
and active exercise of joints and shoulders 
three times weekly. She attends cooking 
class as part of her occupational therapy 
program. Her favorite pastimes are color- 
ing and painting, which she does rather 
well, holding a pencil or brush between 
36 THE CANADIAN NURSE 



the backs of her bandaged hands. Each 
drawing usually occupies a full page, is 
very colorful, and full of small details. 
She often has a central figure doing things 
for younger children - caring for them - 
and as a rule the "younger" children in 
her drawings are using aggressive words, 
such as "no," or "no, I don't." 

Because of the severity of her physical 
disability and her need for considerable 
medical treatment, Marie has attended 
school irregularly. As a result she has 
advanced only to the grade 4-5 level, and 
in fact some of her work is still at the 
grade 3 level. She is presently reading at 
the grade four level; her spelling is within 
the grade five level, but her mathematical 
ability is only within the grade three 
range. Her teachers are encouraging, 
however. They note that she is a "hard 
worker, enjoying class activities." 

Intellectually, Marie has the capacity 
for further academic achievement. Chil- 
dren of her intellect usually can achieve 
grade eight standing. Since she is interest- 
ed in continuing her education, she will 
no doubt complete this level. 

Marie, too, underwent psychological 
testing. The first such examination was 
carried out when she was just two months 
of age. Her general level of intellectual 
functioning was found to be within the 
lower range of the dull normal grouping 
(l.Q. 80-90). 

Just prior to her admission to hospital, 
she was again tested. While her level of 
intellectual functioning remained essen- 
tially the same, she appeared to have the 
potential to function within the low 
average range. It is possible that the 
hospital environment failed to provide 
her with sufficient stimulation on a con- 
sistent basis to enable her to funcfion on 
the higher level. 

Marie's emotional development 
presents another aspect that must be 
considered in relation to her physical 
illness, and not just as the end result of an 
impoverished institutional life in terms of 
human affection. There are times when 
she is upset and angry, with subsequent 
physical distress, but she is unable to 
verbalize her feelings or to "act them 
out" in aggressive behavior. She considers 
"good" behavior in terms of provision of 
physical care. An expression of anger is 
"bad" since it may mean the withholding 
of the care that she needs. 

"Physical care increase" satisfies 
another of her strong needs. Her passive 
dependency needs - the need to rely 
upon, to be cared for, to be given 
psychological support — come into the 
open especially at times of emotional 
stress. Marie likes to be the center of 
attenfion. 

Her lack of family relationships is 
compensated for by a close relationship 
with a mature nurse — a member of a 
religious order — who is extremely inter- 
ested in Marie and able to give her the 



necessary psychological support. She 
visits Marie regularly, is always available 
by telephone, and has become a mother 
figure for the little girl. 

Although bodily contacts are frequent- 
ly painful, Marie likes her friends to pat 
her occasionally, and appreciates the 
close contact that she has with the nurses 
during her early morning treatments. 
"One more dressing and 1 am ready to 
hug you," was the remark overheard one 
morning as Marie and her nurse finished 
off that part of her daily routine. 

Conclusion 

You have read about two children 
whose hopes for the world of tomorrow 
may remain unfulfilled. The songs that 
they can sing are perhaps less sweet than 
those they had dreamed of singing. Their 
wishes are no less noble because they may 
never be realized. 

With knowledge, experience, and 
physical help, we can make little lives 
such as these not just more tolerable but 
as happy as possible. As nurses we must 
think positively when caring for such 
children. We must be like the miner who 
remarked that he had hunted for gold for 
25 years. He was asked how much he had 
found. "None," he replied, "but the 
prospects are good! " 

Bibliography 

Andrews, G.C. Diseases of the skin, Phila., W.B. 

Saunders, 1954. 
Fox, T. Notes on unusual or rare forms of skin 
disease. IV. Congenital Ulceration of skin (2 
cases) with pemphigus eruption and arrest of 
development generally. Lancet 1:766-767, 
May 31, 1879. 
Greenberg, S.I. Epidermolysis bullosa. Arch. 

Derm. 49:333-334, May 1944. 
Herlitz, G. Kongenitaler Nicht Syphilitischer 
Pemphigus: Fine Ubersicht Nebst Beschrei- 
bung Finer Neuen Krankheitsform (Epider- 
molysis Bullosa Hereditaria Letalis). Acta 
Paediat 11:315-311, 1935. 
Lewis, I.e., Steven E.M., and Farquhar, J.W. 
Epidermolysis bullosa in the newborn. Arch. 
Dis. Child 30:277-284, June, 1955. 
Lowe, L.h. Arch. Derm. 95:6:587, June 1967. 
Noojin, R.O., Reynolds, J.P. and Croom, W.C. 
Genetic study of hereditary type of epider- 
molysis bullosa simplex. Arch. Derm. 
65:477^83, April 1952. 
Severin, G.L., and Farber, E.M. The manage- 
ment of epidermolysis bullosa in children. 
Arch. Derm 95:3:302-308 Uaich 1961. 
Shah, M.A. and Shah, M. Essential shrinkage of 
the conjunctiva in epidermolysis bullosa 
hereditaria. Brit. J. OphthaL 39:667-672, 
Nov. 1955.. 
Swinyard, C.A., Swenson, J.R. and Reeves, 
T.D. Rehabilitation of hand deformities in 
epidermolysis bullosa. Arch. Phys. Med. and 
Rehab. 49:3:138-142, March 1968. D 



FEBRUARY 1969 



Hyperbaric oxygen units 
— high pressure nursing 

A hyperbaric oxygen unit offers a new kind of high pressure challenge for a nurse. 
She has to handle emergency treatments, surgery, bedside care, reassurance, and 
teaching — all carried out in a tiny submarine-like chamber that simulates 
treatment at undersea pressures. 



Glennis Zilm 



One day last year a young Ontario 
man caught his hands in a farm reaping 
machine. The wounds were large, open, 
and deep; as well as the severity of the 
wounds, an immediate danger was a gross 
fulminating gas gangrene infection that 
became apparent right from the time he 
arrived at the local hospital. 

After preliminary emergency treat- 
ment - suturing and bandaging of the 
wounds - he was transferred immediately 
to the Toronto General Hospital. By that 
time, crepitus - the most dread symptom 
of the anaerobic infection — could be 
heard in the shoulders and chest walls. 
His blood pressure (taken on the leg) was 
low, pulse was 180, respirations 40-50, 
and temperature 105 degrees. 

With only the classical methods of 
treatment — antibiotics, serum, and 
surgery — this young man would have 
died. He lived and recovered because the 
Toronto General Hospital has a hyper- 
baric treatment unit. 

Hyperbaric oxygen is rapidly gaining 
value as a treatment method in various 
parts of the world. Although techniques 
of subjecting a patient to increased 
atmospheric pressure were used as early 
as 1662 and were in vogue in the 1800's, 
only within the last decade have the 
therapeutic possibilities been chnically 
researched. 

Major investigation into modem uses 
of hyperbaric oxygen therapy was first 
begun in Amsterdam, Holland, in 1956. 
Since that time units have been set up in 
many parts of the world. The Royal 
Victoria Hospital in Montreal established 
the first Canadian medical hyperbaric 
FEBRUARY 1969 



oxygen chamber in October, 1963. 
Toronto General Hospital opened its unit 
in 1964, and The Vancouver General 
Hospital opened a unit in 1965. 

Much background information on 
hyperbaric treatment developed from the 
techniques evolved to enable man to 
build or repair structures under water. 
Atmospheric pressures had to be raised 
inside diving bells or caissons to corres- 
pond to the increased water pressures 
outside, and modem medical research 
relies on knowledge of decompression 
sickness, nitrogen narcosis, and other 
physiological and psychological changes 
documented by deep-sea diving teams. 

Uses 

The use of hyperbaric oxygen implies 
that the patient is breathing in an atmos- 
phere in which the pressure is greater 
than atmospheric pressure (at sea level), 
and in which he is provided with an 
increased intake of oxygen (usually by 
mask). As a result, oxygenation at the 
cellular level is improved. 

In normal atmospheric conditions and 
breathing air, a person will show a partial 
pressure of oxygen in arterial blood p02 
of approximately 100 mm. Hg. Under 
normal atmospheric conditions but 
breathing pure oxygen, the subject can 
raise his arterial p02 to 500-600 mm. 
Hg. At three atmospheres pressure, the 
subject will show an arterial p02 in- 
creased to 1500-1800 mm. Hg. The 
amount of oxygen dissolved into plasma 

Miss Zilm was assistant editor of the canadun 
NURSE at the time this article was prepared. 



is directly related to the p02 so in 
hyperbaric conditions the amount of 
oxygen available to body fluids and 
tissues is greatly increased. 

This increase of oxygen at the cellular 
level is useful in treating conditions such 
as infections where lack of oxygen plays a 
part (gas gangrene), carbon monoxide 
poisoning, decompression sickness 
(bends), ischemic diseases (threatened 
gangrene, frostbite), and, in some instan- 
ces, shock. 

It may also help in s6me respiratory or 
cardiac diseases, selected cardiovascular 
accidents, plastic surgery, and vascular 
occlusion where a terriporary ischemic 
state may be reversed by medical or 
surgical treatment. 

Hyperbaric oxygenation also appears 
to be effective as an adjunct to radiation 
therapy and to some of the newer drug 
therapies in the treatment of malignant 
tumors. The theory behind the use of 
hyperbaric oxygen treatment in malignan- 
cies is based on recent discoveries that 
tumor cells, because of the mass, are 
often anoxic and have poor blood supply. 
Normal cells, which have a good blood 
supply and less pressure, are not overly 
affected when subjected to hyperbaric 
oxygenation, but the oxygen supply to 
the tumor cells is increased, and the 
effect of the radiation or drug is enhan- 
ced at the cancer site. 

Side Effects 

Not all the effects of hyperbaric oxy- 
genation are beneficial, although in 
normal therapeutic situations side effects 
are minimal. Two main types of side 
THE CANADIAN NURSE 37 




The members of the hyperbaric unit staff gather around to help lift the patient into the submarine-shaped chamber. A special 
carrier helps slide the stretcher over the sill of the port-hole type door. 



effects occur: physiologic and/or mechan- 
ical. 

An adverse effect of oxygen at increas- 
ed pressure is oxygen toxicity or oxygen 
poisoning. Although little is known about 
the mechanism, lengthy exposure to high 
concentration of oxygen even at normal 
pressures leads to central nervous system 
disturbance. Warning signs - sudden 
apprehension, circumoral pallor, vertigo, 
nausea, choking sensation, tremor — 
lasting 20 to 30 seconds may precede 
generalized convulsion. If oxygen is ter- 
minated immediately and the patient 
allowed to breathe air, recovery is prompt 
and no adverse effects are noted. 

Oxygen toxicity is extremely rare in 
therapeutic concentrations, such as two 
to three atmospheres for two hours or 
less. However, in attempts to find out 
more about the condition, investigations 
are being carried out with electroence- 
phalograms (EEC) as a means of indenti- 
fying oxygen toxicity in its earliest stages. 

As well as this physiologic oxygen 
toxicity effect, mechanical side effects 
are produced upon gases within the body. 
Under hyperbaric conditions, gas in body 
air spaces becomes compressed. Then, if a 
rapid decompression occurs, the expand- 
ing gas gets trapped in these spaces — or 
bubbles may even appear in blood or 
tissues — and this may cause serious 
pressure effects. 

Decompression sickness, or "bends," is 
the name given to the symptoms occurr- 
ing when a person has come up too 
rapidly from a depth. It is occasionally 
seen when deep-sea divers must be 
brought to the surface too quickly. The 

38 THE CANADIAN NURSE 



theory is that minute gas bubbles occur in 
the blood or tissue. In the early stages, it 
causes severe joint and muscle pains; 
later, it may even lead to death. The 
nitrogen component in normal air is the 
most likely to cause bubbles in blood or 
tissues as nitrogen is not metabolized by 
the body in any way; the specially con- 
trolled therapeutic atmosphere of pure 
oxygen is much less likely to cause gas 
bubbles in blood or tissues. 

Body air spaces usually affected are 
the ear chambers, the gastrointestinal 
tract, sinuses, and the lungs. During 
pressure changes, air enters or leaves the 
middle ear cavity through the normally- 
closed eustachian tube, thus equalizing 
pressure on the tympanic membranes. 
Should the eustachian tube not open 
freely when the pressure is reduced 
following treatment, the eardrum may 
stretch as the trapped gas expands, 
causing pain or even perforation. Persons 
with conditions that contribute to 
blockage of the eustachian tubes — such 
as head colds or sinusitis — are usually 
not candidates for hyperbaric work. 
Patients who require therapy may require 
a myringotomy to prevent middle ear 
discomfort. 

Gas in the gastrointestinal tract, 
caused by either swallowing air or by gas 
production while in the hyperbaric 
atmosphere, may lead to abdominal 
distention during decompression. Anxiety 
is a contributing factor because the 
anxious person is prone to both excessive 
air swallowing and increased gastrointes- 
tinal activity. Diets with a low intake of 
gas-producing foods may help. 



Mechanical effects on the respiratory 
system have serious complications. 
Compressed gas trapped in a respiratory 
passage, such as through obstructions 
such as mucous plugs or breath holding 
because of fright, can cause rupture of 
alveoli, or even pneumothorax, interstitial 
emphysema, or air embolism during 
decompression. Special care must be 
taken with persons who have any symp- 
toms of respiratory conditions. 

Minor mechanical effects are experi- 
enced when gas is trapped in small air 
spaces, such as between the teeth, and 
causes pain on expansion; occasionally 
patients will complain of this. 

Decompression sickness and the 
mechanical side effects of exposure to 
high pressures are avoided by gradual, 
staged decompression. Specific regula- 
tions on the amount of time required for 
decompression are controlled by an 
experienced operator outside the cham- 
ber. 

The controllers — non-medical person- 
nel who operate the pressure equipment 
of the chambers in Canada's three units — 
are all former Navy personnel who have 
spent most of their lives in this work. 
They are fully aware of the dangers of 
decompression, having experienced pres- 
surization and decompression many 
times. When decompression is carried out 
gradually and the patient and personnel 
adequately prepared psychologically, the 
effects are minimal and not bothersome. 

Taking a dive 

The team needed for hyperbaric 

treatment includes a doctor and nurse 

FEBRUARY 1%9 



specially prepared in the method of 
treatment, and qualified controllers who 
regulate the pressure equipment for the 
chamber. Medical staff must be trained in 
the uses and effects of hyperbaric 
treatment, and they must be qualified 
"divers." 

Vicid Kent, a graduate of The Vancou- 
ver General Hospital and charge nurse of 
the Hyperbaric Unit at the Toronto 
General Hospital, explained the orienta- 
tion procedure for new nurses who come 
to work on that unit. A preliminary 
screening of applicants is carried on by 
the nursing department, and then the 
applicant reports to the Hyperbaric Unit. 
Mrs. Kent arranges for a physical check- 
up to ensure that the nurse is physically 
fit for exposure to hyperbaric pressures, 
to provide base line findings that would 
be available if any complaints developed 
after diving, and to provide control 
findings for research on the effects of 
repeated exposures to dives. 

The physical screening procedures 
include a physical examination, ear-nose- 
throat examination, audiogram, vital 
capacity and pulmonary function tests, 
electrocardiogram, blood tests, urinaly- 
sis, electroencephalogram, eye exami- 



nation, and full chest plate and x-ray of 
long bones. These are carried out by the 
various hospital departments, which are 
aware of the special interests of the 
hyperbaric oxygen department. Results 
are sent to the Unit. 

After the nurse has passed her 
physical, she reports for a chamber 
pressure and oxygen tolerance test under 
the supervision of Mrs. Kent or one of the 
doctors assigned to the unit. The apph- 
cant and the examiner enter the chamber 
and "descend" to a pressure equivalent to 
165 feet below sea level (six times atmos- 
pheric pressure). This is an unusually 
deep dive, and it is unlikely that the nurse 
will ever need to go to that depth again, 
but she learns what it is like, and she has 
a chance to determine her tolerance to 
pressure. Dives of 100-165 feet may be 
required to treat patients suffering from 
decompression sickness; therapy dives are 
usually only 33-66 feet. 

Before and during the dive, the examin- 
er explains what is going on and how to 
minimize side effects. Staff are taught the 
Valsalva manoeuver to equalize ear 
pressure (this involves a kind of yawn 
that stretches the openings to the eusta- 
chian tubes and permits the pressure in 




Several types of chambers are used for hyperbaric treatment. Tfiis small, patient- 
only tank is used quite extensively in Britain 
FEBRUARY 1969 



the middle ear to be equal to that in the 
outer ear). 

After a few moments at 165 feet, the 
pair "come up" to 60 feet of pressure, 
and the applicant then takes 30 minutes 
on straight oxygen. During this period the 
examiner watches for any evidence of 
oxygen toxicity, and uses the time for 
discussion of equipment kept in the 
chamber, the type of conditions that are 
generally treated, and so on. 

After the applicant has finished this 
part of the examination, she and the 
examiner "come to the surface." The 
applicant must stay on hand in the unit 
for at least 30 minutes, and this time is 
used for teaching — about pressure, 
emergencies, and about the Ufe and death 
aspects of fire safety and pressure con- 
trol. 

The most serious worry for staff in the 
units is fire, and all staff must be extreme- 
ly fire conscious. Chambers are made 
as safe as possible. All monitoring and 
electrical equipment is isolated outside 
the chamber and any equipment in the 
chamber has passed rigid safety codes. 
Any materia] or equipment taken into the 
chamber is screened by a fire-conscious 
controller. All clothing, bedding, wrap- 
pers, and such are made of fire-resistant 
cloth or have been treated to be fire 
resistant. No oils, lubricants, or other 
combustible materials are used. If anes- 
thetics are to be used, they must be 
non-combustible, and this has created 
special challenges to the anesthetists in 
some instances. Anesthetic gases are 
avoided. 

Safety features include fire blankets 
that are kept inside the chambers, an 
automatic sprinkler system, and individ- 
ual face masks for every person in the 
chamber. If a fire should start, the oxy- 
gen flow shuts off, and compressed air is 
delivered through the masks. 

As J.H. Wilson, chief controller of 
Toronto General's Unit explains, "If all 
fire rules are followed, then there really is 
no danger." Staff are constantly aware of 
just how much the rules reaUy mean to 
them. 

The applicant, if she has passed all the 
tests so far, then comes back to the unit 
for another dive — this time to learn a bit 
about the working of the pressure con- 
trols from inside the chamber. Although 
the nurses become quite knowledgeable 
about the pressure controls, they only 
practice at low pressures and only moving 
"down." 

Treatment dives 

Work in the three chambers in Canada 
involves about one-half the dives with 
patients for treatment; the other half of 
the dives are for research experiments. In 
all three centers, medical staff carry out 
experiments on animals to test the effects 
of hyperbaric oxygen exposures and to 
learn ways that it may be used more 
THE CANADIAN NURSE 39 



effectively in the future. 

J^ost of the treatment work at 
Toronto General is emergency work; the 
other two centers do more routine 
treatments, such as adjunct therapy for 
cancer treatments and routine treatment 
for plastic surgery. 

The chamber in Toronto is too small 
for surgical procedures, although some 
experimental surgery is carried out on 
animals there. 

In The Vancouver General Hospital's 
the largest in Canada, they have done 
some surgery, although it is very 
crowded. The chief controller, E.D. 
Thompson, has used his ingenuity to save 
any extra bit of space inside the chamber. 
and has even adapted French racing car 
headlights as operating lights as they are 
small, yet provide excellent illumination. 

Emergency call 

Although the Toronto Unit is only 
staffed with nurses on a part-time, day- 
time only, five-day week basis, a control- 
ler is on call at all times. He calls in nurses 
and doctors from the lists of personnel 
prepared to work on the unit. 

The doctor on call is usually contacted 
first, and only he can approve a dive. He 
arranges for the other staff to be called 
in. Either the doctor or a nurse dives with 
the patient, and another medical staff 
member (either doctor or nurse) must be 
on hand outside the chamber with the 
controller. 

When the young patient with gas 
gangrene, mentioned at the beginning of 
the article, arrived at the Toronto Gener- 
al's emergency department, the hyper- 
baric unit staff were called in. Witliin one 
hour he was in the chamber. The doctor 
"went down" with him; one nurse and 
two controllers were on hand outside the 
chamber. "We really didn't have time to 
do any psychological preparation as the 
patient was too Ul to wait, but the staff 
tried to explain fully as they went along," 
said Mrs. Kent. "He was only semicons- 
cious, and delirious at times. He had a 
myringotomy in emergency to help 
relieve any ear pressure." 

This patient was taken to 66 feet 
(three atmospheres) very quickly. He 
then went on 100 percent oxygen for 
about 60 minutes. The improvement in 
his condition was dramatic, and after 
decompression he was taken to the operat- 
ing room for debridement. 

Immediately following the operation, 
he was returned to the chamber for 
another hyperbaric oxygen treatment, 
and these were repeated every four to six 
hours for a few more dives. The hyperbar- 
ic oxygen treatment saved his life. D 




77;e chamber at the Toronto General Hospital is large enougli for a patient and one or 
two staff. A small entrance chamber permits another staff member to enter after the 
main chamber has been pressurized. 




40 THE CANADIAN NURSE 



Tfiere's not much extra room inside the chamber - everything must be in its specific 
place. In this photo, the nurse is wearing fire-resistant clothing. 

FEBRUARY 1%9 



Clinical Laboratory Procedures 



This is a 1%9 revision of the summary first published in 1949 and 
subsequently brought up-to-date in 1956 and 1960. 



E.M. Watson, M.D., F.R.C.P. (C) 

Revised by A.H. Neufeld. M.D.. Ph.D., F.C.I. C. 



Everyone associated with the activ- 
ities of a large, modem general hospi- 
'tal must be impressed and at times 
confused by the increasing number of 
laboratory tests that are performed on 
patients. It is, therefore, pertinent that 
the interest of the nursing staff in labor- 
atory investigations should not be lim- 
ited to mere formalities such as fil- 
ling out requisition forms, directing the 
technician or the I.V. nurse to the pro- 
per patient, and collecting and label- 
ling of specimens. While these func- 
tions represent important responsibili- 
ties of the nurse in relation to the 
proper conduct of laboratory tests, no 
doubt she will exert a more intelligent 
interest in her duties and have a better 
understanding of the patient if she pos- 
sesses some knowledge of the proce- 
dures that are carried out. With a view 
to supplying relevant information in a 
condensed form, the following tables 
are presented. 

The arrangement has been changed 
appreciably since the last revision. This 
is based largely on the usual functional 
and administrative divisions in the up- 
to-date hospital laboratory. The follow- 
ing order is not necessarily in order of 
importance. 

Hematological values 

Blood, plasma or serum biochemis- 
try values 

Urine biochemistry values 

Cerebrospinal fluid values 

Blood Bank values 

Function tests and investigations 

FEBRUARY 1969 



Tests identified by proper names 

Frequently laboratory tests are or- 
dered by using only the man's name, 
even though other terms might apply 
equally well and actually should have 
been used. Technical and analytical 
procedures often are known best by 
the names of the men who discovered 
them or were associated with their de- 
velopment and popularization. The 
most commonly used terms encounter- 
ed follow: 

Bence-Jones protein — the abnormal 
protein found in the urine of about 
50 percent of patients with myeloma 
Bodansky unit — the amount of phos- 
phatase required to liberate 1 mg. of 
phosphorus; test result for alkaline 
or acid phosphatases (see also Sig- 
ma) 
Coombs — a test used in pregnant 
women and newborn infants relative 
to Rh sensitization; also used in he- 
molytic anemias 
Duke — a method for determining the 
bleeding time of a patient 

Dr. Watson, now semi-retired, was for- 
merly Professor of Pathological Chemistry, 
Senior Associate in Medicine, Faculty of 
Medicine, The University of Western On- 
tario, and Clinical Pathologist at Victoria 
Hospital, London, Ontario. 

Dr. Neufeld is Director of Clinical Path- 
ology at Victoria Hospital, London, Ontario, 
and Head and Professor in the Department 
of Pathological Chemistry at the University 
of Western Ontario, London, Ontario. 



Fishberg (concentration or dilution 
test) — kidney function test to eval- 
uate the kidney's ability to concen- 
trate or dilute urine 

Frei — a skin test for a venereal dis- 
ease, lymphopathia venereum 

Friedman — a test for pregnancy 

Hinton — a test for syphilis 

Ivy — a method for determining the 
bleeding time of a patient 

Kahn — a test for syphilis 

Kepler or Kepler-Power — procedures 
for the diagnosis of Addison's dis- 
ease 

King-Armstrong unit — an amount of 
phosphatase required to liberate 1 
mg. of phenol; test result for alkaline 
or acid phosphatases 

Kline — a test for syphilis 

Kolmer — a test for syphilis 

Lange's Colloidal Gold — a test on 
C.S.F. as an aid in diagnosis 

Lee and White — a test of blood coag- 
ulation time, using venous blood 

Mosenthal — a two-hour specific grav- 
ity volume test for evaluating kid- 
ney function 

Papanicolaou — a technique for the 
identification of cancer cells 



Reprints of this article are available at the 
following rates: single copy — $1.00; 100 
copies — $80 ($10 for each additional 100) 
1000 copies — $160 ($80 for each addition- 
al 1000). Send order and covering remit- 
tance to CNA Publications, 50 The Drive- 
way, Ottawa 4, Canada. 

THE CANADIAN NURSE 41 



Quick — a technique for estimating 
prothrombin (refers to a man's 
name, not speed of performance) 

Paul-Bunnell — a serological test for 
infectious mononucleosis 

Rumple-Leede — not a laboratory test, 
but a method for determining capil- 
lary fragility by inflating a blood 
pressure cuff and counting the pete- 
chiae in a circumscribed area of skin 

Schilling — a radioisotope test for per- 
nicious anemia 

Sigma — the amount of phosphatase 
required to liberate 1 mg. of phos- 
phorus; test result for alkaline or 
acid phosphatases (see also Bodart- 
sky) , 

Singer — latex fixation test used in 
connection with rheumatoid arthri- 
tis 

Somogyi — often referred to in relation 
to serum amylase 

Sulkowitch — a test for calcium in 
urine 

Van den Bergh — a test for liver func- 
tion 

Wassermann — the original test for 
syphilis 

Watson — a test for urobilinogen in 
urine and feces 

Westergren — a technique for perform- 
ing the sedimentation rate 

Widal — a serological test for typhoid 
and paratyphoid fevers 

Wintrobe — a special tube for deter- 
mining red cell volume and sedimen- 
tation rate 

Ziehl-Neelsen — a stain for acid-fast 
bacteria, usually for tubercle bacilli 

Abbreviations and symbols 

ABO — the main blood group system 

Ac. — acid 

A.C.D. — anticoagulant used in pre- 
served blood 

A.C.T.H. — Adrenocorticotrophic 
hormone 

A:G ratio — a figure obtained by di- 
viding the value for the plasma or 
serum albumin by that for the glob- 
ulin 

Alk. — alkaline 

A.-Z. test — Ascheim-Zondek, a test 
for pregnancy 

A.F.B. — acid-fast bacillus; a charac- 
teristic staining quality of the tub- 
ercle bacillus 

Av. — average 

B.M.R. — basal metabolic rate 

B.S. — blood sugar 

B.S.P. — bromsulphalein; a liver func- 
tion test 

B.T. — bleeding time 

B.U.N. — blood urea nitrogen 

C. — centigrade 

Ca. ■ — calcium 

cc. — cubic centimeter 

C.C.F. — cephalin-cholesterol floccu- 
lation test; a liver function test 

CI. — chlorine 

42 THE CANADIAN NURSE 



CO2C.P. — carbon dioxide combining 

power of blood plasma 
C.P.K. — the enzyme creatine phos- 

phokinase 
Creat. — creatinine; a constituent of 

blood and urine 
C.R.P. — C-reactive protein 
C.S.F. — cerebrospinal fluid 
Cu. — copper 
C.V.I. — cell volume index 
Diff. — differential; used with refer- 
ence to a smear of blood or C.S.F. 
to determine the types and percent- 
ages of the white blood cells present 
ECG or EKG — electrocardiogram 
EDTA — an anticoagulant, frequently 
used n blood samples for hematol- 
ogy , , 
EEC — electroencephalogram 
Eos. — eosinophil; a variety of white 

blood cell 
E.S.R. — erythrocyte sedimentation 

rate; sedimentation rate 
F. — Fahrenheit 
F.B.S. — fasting blood sugar 
Fe. — iron 
F.S.H. — follicle stimulating hormone 

of the pituitary gland 
g. or gm. — gram 
G.A. — gastric analysis 
G.C. — gonococcus; the causative or- 
ganism of gonorrhea 
g.i. — gastrointestinal 
HCG — human chorionic gonadotro- 
phic factor. This factor is present in 
pregnancy (pregnancy test) and ma- 
lignant tumors of the testes 
Hg. or Hgb. — hemoglobin 
H. & E. — hematoxylin and eosin 
stain; used in the preparation of 
pathological material for examina- 
tion 
5HIAA — 5-hydroxyindoleacetic acid 
Ht. — hematocrit 
Ig — the blood immunoglobulins, such 

as IgA, IgG, IgM, etc. 
I.I. — icteric index; a chemical test on 
serum to reveal the degree of jaun- 
dice 
ICDH — isocitric dehydrogenase, a tis- 
sue enzyme 
I.M. — intramuscular 
I.V. — intravenous 
K. — potassium 

17KGS — 17-ketogenicsteroids, a 
group of hormones in the urine from 
the adrenal cortex 
17KS — 17-ketosteroids; a hormone 
assay on urine to study adrenal or 
other glandular disorders 
L. or 1. — liter 

L.D.H. — the enzyme lactic dehydro- 
genase 
L.E. — lupus erythematosus 
Lymph. — lymphocyte; a variety of 

white blood cell 
ml. — milliliter; 1/1000 part of a liter; 
approximately the same as cc. but a 
more exact expression of measure- 



ment 
M.C.H. — mean corpuscular hemo- 
globin 
M.D.H.C. — mean corpuscular hemo- 
globin concentration 
M.C.V. — mean corpuscular volume 
mEq. — milliequivalent 
mEq./l. — milliequivalent per liter 
mg. or mgm. — milligram 
Myelo — myelocyte; the forerunner of 

the granular leukocytes 
N. — nitrogen 
Na. — sodium 
Neut. — neutrophiles; a variety of 

white blood cell 
N.P.N. — non-protein nitrogen 
O2 — oxygen 
O.T. — old tuberculin; a skin test for 

tuberculosis 
p.a. — pernicious anemia 
Pap. stain — Papanicolaou stain for 

cancer cells 
P.B.I. — - protein-bound iodine; an es- 
timation used in connection with 
thyroid function 
pH — a symbol used to express acidity 

and alkalinity 
pCOi; — partial pressure of carbon 

dioxide 
PI. Ct. — blood platelet count 
P.S.P. — phenolsulphonphthalein test; 
a method for assessing kidney func- 
tion 
R.A. — rheumatoid arthritis 
r.b.c. — red blood cell count 
R.F. — rheumatoid factor, present in 
blood in rheumatoid arthritis and 
occasionally in lupus erythematosis 
Rh — Rhesus; the Rh factor 
Retic. — reticulocyte 
RISA — radio iodinated serum albu- 
min, a material for measuring plas- 
ma volume 
S.G.O.T. — serum glutamic-oxalacetic 

transaminase 
S.G.P.T. — serum glutamic-pyruvate 

transaminase 
S.I. — saturation index; a test used in 

hematology 
Sp. Gr. — specific gravity 
TSH — thyroid stimulating hormone 

of the pituitary gland 
T3 — an in vitro test for thyroid func- 
tion 
T4 — a test for thyroxine, the thyroid 

hormone 
T.P.I. — Treponema pallidum immo- 
bilization: a specific test of serum 
for syphilis 
U.A. — urine analysis 
Ur. Ac. — uric acid 
M — micro 
MM — micro micro 
VMA — Vanilmandaelic acid, a test 

for adrenal medulla function 
w.b.c. — white blood cell count 
W.R. — Wassermann reaction 
V.D.R.L. — flocculation test for sy- 
philis 

FEBRUARY 1%?' 



Hematological Values 

Most hematological analyses are carried out on blood collected either in a potassium- 
ammonium oxylate or in EDTA. Exceptions to this are the prothrombin and partial 
thromplastin time, collected in fluid anticoagulant, and the LE preparation on clotted 
blood. Usually from 3-7 ml. is adequate for analyses. 



Determination 


Normal Value 


Clinical Significance 


Autohemolysis 


0.5-3.6% without glucose 
0.1-0.8% with glucose 


differential test for certain 
anemias (spherocytoxic) 


31eeding time 
Duke) 


1-3 min. 


prolonged when platelets reduced 
(as in thrombocytopenia purpura) 


31ood volume 


60-90 ml./kg. 


increased in polycythemia vera; 
decreased in dehydration, shock, 
hemorrhage, postoperatively, etc. 


Carbon monoxide 
lemoglobin 


none 


in carbon monoxide poisoning or 
intoxication (car exhaust, etc.) 


dot retraction 


complete and perfect 
in 24 hours 


delayed and imperfect in thrombo- 
cytopenia purpura (platelet deficiency) 


Coagulation 
.clotting time) 


8-18 min. (test tube method); 
1-5 min. (capillary 
tube method) 


prolonged in hemophilia, also 
after heparin administration 


i)ifferential 
/hite cell count 


Mature neutrophils 

52-70%; 3,000-6,000 cu.mm. 

Young neutrophils 

3-5%; 150-400 

Eosinophils 

1-4%; 50-400 

Basophils 

0-1.5%; 15-150 

Lymphocites 

20-35% (up to 50%; in 

children) 1,500-3,000 

monocytes 

2-6%; 100-600 


increased in many infections; 
decreased in agranulocytosis 

increased in many allergic 
conditions 

increased in lymphocytic leukemia, 
infectious mononucleosis and 
whooping cough 


ibrinogen 


200-500 mg./lOO ml. 
Fibrindex — less than 
60 sec. 


decreased or prolonged in 
severe liver disease and in a 
complication of pregnancy 


olic acid 


5-21 m^g./ml. 


decreased in some of the anemias 


lemoglobin 


Adult male: 

14-17.5 g./lOO ml. 

Adult female: 

12-15.5 g./lOOml. 

Children: 

11-13 g./lOOml. 

Infants (1 day to 2 

weeks): 15-22 g./lOO ml. 


decreased in the anemias; increased 
in polycythemia and hemo- 
concentration (shock, burns, 
myocardial infarction) 

decreased in hemolytic disease of the 
newborn (erythroblastosis) 


-EBRUARY 1%9 




THE CANADIAN NURSE 43 



Determination 



Hematocrit 



Iron binding 
capacity 



L.E. preparation 



Mean corpuscular 
hemoglobin 



Mean corpuscular 

hemoglobin 

concentration 



Mean corpuscular 
volume 



Paul-Bunnell 

(heterophile 

antibodies) 



Partial thromboplastin 
time (PTT) 



Prothrombin time 



Plasma hemoglobin 



Plasma volume 



Platelets 



Radioiron clearance 
(■-■"Fe) 



Normal Value 



Male: 40-54% 
Female: 37-47% 



220-400 Mg./lOO ml. 



none 



27-32 MMg 



33-38% 



80-94/cu. M 



negative 



0.34% 
40-60 sec. 



12-16 sec, reported 
with control 



0-4.0 mg./lOO ml. 



34-60 ml./kg. 



150,000-450,000/cu. mm. 



T 1/2— 120 min. 



44 THE CANADIAN NURSE 



Clinical Significance 



decreased in the anemias; 
increased in polycythemia and 
hemoconcentration 



decreased in hemolytic anemia 
and hemochromatosis 



positive in lupus erythematosis 



increased in macrocytic anemia 
(e.g. pernicious anemia); low 
in hypochromic anemia 



same as above 



same as above 



a test for infectious mononucleosis 



a test for hemophilia-like states 



mainly used in control of 
anticoagulant therapy 



increased in hemolytic anemia and 
other hemorrhagic processes (mis- 
matched blood, etc.) 



decreased in hemoconcentration; 
increased in some with hypertension, 
Paget's disease and some other clinical 
conditions 



decreased in thrombocytopenia 
purpura and other clinical conditions 



decreased in iron deficiency; 
increased in hemosiderosis and 
aplastic anemia 



Red blood cell 


Adult male: 


decreased in the anemias; 


count 


4-5 million/cu.mm. 


increased in polycythemia and 




Adult female: 


hemoconcentration (shock, bums. 




4-5 million/cu.mm. 


myocardial infarction) 




Infants: 






5-7 million/cu.mm. 






at birth, gradually 






decreasing to adult 






at 15 years 





FEBRUARY 1969 











Determination 


Normal Value 


Clinical Significance 


Red blood cell 
volume (i"I) 


29-33 ml./kg. 


decreased in blood loss; 
increased in polycythemia vera 
and hemoconcentration 


Red cell fragility 
(osmotic fragility 
test) 


hemolysis begins at 
0.43% NaCl 
hemolysis complete at 
0.34-0.3% NaQ 


fragility increased in hemolytic 
jaundice; decreased in obstructive 
jaundice 


Plasma iron incorporation 

(sspe) 


75% and over in 7-10 
days 


decreased in hemolytic anemia; 
a measure of the rate of formation 
of red blood ceUs 


Plasma iron turnover 

(sspe) 


0.061 mg./day/g.Hg. 


important in study of iron 
metabolism 


Red cell survival 
test (with ^'^Ct) 


Half-life: 25-35 days 


decreased in hemolytic anemias; 
a test for the life span of the 
red blood cell 


Reticulocytes 


0.5-1.5% of all red 
blood cells 


increased in pernicious anemia 
following Vitamin B12 therapy and in 
hemolytic anemias; decreased in 
aplastic and pernicious anemia 


Schilling test 
jadio cobalt 
Vitamin B12) 


10% and over 
(urinary excretion) 


this is a specific test for 
pernicious anemia 


Sedimentation rate 
Westergren) 


Male: 0-9 mm./hr. 
Female: 0-20 mm./hr. 


increased in infectious and 
inflammatory diseases 


Total body water 
tritium space) 


50-70% of body weight 


increased in edema; decreased in 
hemoconcentration (bums, shock, etc.) 


Vitamin B12 


42-410 MMg./ml. 


increased in acute and chronic 
leukemia, infectious hepatitis, liver 
cirrhosis; decreased in the anemias, 
malabsorption, malnutrition 


Blood, Plasma or Serum Biochemistry Values 

In the majority of hospitals, all biochemistry analyses are carried out on serum. However, 
some hospitals still use oxylated blood for ammonia, B.U.N, glucose and N.P.N. 
Amounts of blood required for the analyses range from 5-10 ml. 


Determination 


Normal Value 


Note 


Clinical Significance 


Aldolase 


Male: less than 

33 u. 
Female: less than 

19 u. 




increased in viral 
hepatitis, progressive 
muscular dystrophy, 
myocardial infarction 


FEBRUARY 1969 






THE CANADIAN NURSE 45 



Determination 



Ammonia 



Amylase 



Ascorbic acid 
(Vitamin C) 



Bicarbonate 



Bilirubin 

(Van den Bergh 

test), total 



Bilirubin, 
Direct 



Bromide 



Calcium 



Carbon dioxide, 
CO2 



Carbon dioxide 
partial pressure, 
PCO2 



Normal Value 



10-30 Mg./lOO ml. 



60-160 Somogyi u./ 
100 ml. 



0.6-1.2 mg./lOOml. 



18-25 mEq./l. 



0.1-0.8 mg./lOO ml. 



0-0.2 mg./lOO ml. 



0-1.5 mg./lOO ml. 



9-11 mg./lOO ml. 
4.5-5.7 mEq./l. 



25-35 mEq./l. 



35-45 mm. 



46 THE CANADIAN NURSE 



Note 



test must be done 
immediately 



do not draw during 
or just following 
i.v. glucose or after 
administration of 
morphine 



blood must be placed 
in a tube surrounded 
by ice and sent 
immediately to the 
laboratory 



blood must be drawn 
without stasis from 
toumique 



Clinical Significance 



increased in severe 
liver disease and bleeding 
into gastrointestinal 
tract, especially from 
esophageal varices 



increased in acute 
pancreatitis; also in 
parotitis, perforated 
peptic ulcer, abdominal 
trauma, after morphine, 
etc. 



low in scurvy 



reduced in acidosis; 
increased in alkalosis 



increased in jaundice; 
latent jaundice 0.5-2.0; 
clinical jaundice above 
2.0 



increased in obstructive 
jaundice 



important in the diagnosis 
of bromide poisoning 



low in hypoparathyroidism, 
sprue and steatorrhea; 
increased in hyperpara- 
thyroidism and some bone 
diseases 



increased in alkalosis 
(respiratory obstruction, 
vomiting, ingestion of 
bicarbonate); decreased 
in acidosis (diabetes, 
over breathing, etc.) 



same as above 



FEBRUARY 196S 



Determination 


Normal Value 


Note 


Clinical Significance 


CO2 combining 
power 


55-75 vol. % 




see Bicarbonate above 


Ceruloplasmin 


30-35 mg./lOO ml. 




decreased in Wilson's 
disease 


Chlorides 


96-105 mEq./l. 




decreased in vomiting, 
starvation and after 
gastrointestinal surgery 


Cholesterol, 
Total 


Adults: 150-275 
mg./lOO ml. 

Children: 100-225 
mg./lOO ml. 

Infants: 70-125 
mg./lOO ml. 




increased in hypo- 
thyroidism, diabetes and 
nephrosis; also in 
conditions associated with 
hyperlipemia; in 
hypercholesterolemia 


Cholesterol, 
Free 


50-60 mg./lOO ml. 




same as above 


Cholinesterase 


0.62-1.26 u. 




decreased in hepato- 
cellular jaundice, advanced 
cirrhosis, after hepato- 
toxic agents 


Copper 


80-120 /ig./lOO ml. 




decreased in Wilson's 
disease (hepatolenticular 
degeneration) 


Creatinine 


1-2 mg./lOO ml. 




increased in severe 
nephritis 


Creatine phosphokinase 


up to 0.72 milli u. 




increased in muscle wasting 
disease, muscle trauma, 
pulmonary infarction 


C-reactive 
protein 


negative 




increased in rheumatic 
fever, rheumatoid arthritis, 
lupus, myocardial 
infarction, pneumonia, 
pregnancy, etc. 


Glucose 
:fasting) 


70-100 mg./lOO ml.; 

total reducing 

substance 

80-120 mg./lOO ml. 


up to 140 or 160 
after meals 


increased in diabetes 
mellitus, Cushing's disease; 
decreased in hyper- 
insulinism 


1 7-Hydroxycorticosteroids 


5-20 Mg./100 ml. 


heparinized blood 


increased in Cushing's 
disease, moderate in 
infections, bums, surgery; 
decreased in Addison's, etc. 


iron. 


50-200 /xg./lOO ml. 




increased in hemolytic 
anemias, hemochromatosis; 
decreased in iron 
deficiency anemia 



FEBRUARY 1969 



THE CANADIAN NURSE 47 











Determination 


Normal Value 


Note 


Clinical Significance 


Isocitric 

dehydrogenase 

(ICDH) 


50-260 u. 




increased in diseases of the 
liver 


Lactic 

dehydrogenase 

(L.D.H.) 


up to 450 u. 




increased in myocardial 
infarction, liver diseases, 
etc. 


Lipase 


0.2-1.5 u. 




mcreased in acute 
pancreatitis 


Lipids (total) 


450-850 mg./100 ml. 




increased in diabetes, 
xanthomatosis, hyper- 
lipemia 


Magnesium 


1.3-2.5 mEq./l. 


draw in polyethylene 
tube 


changed in various un- 
related diseases; also 
magnesium poisoning 


Non-protein 
nitrogen (NPN) 


25-35 mg./lOO ml. 




see B.U.N, above 


pH 


7.35-7.45 


drawn in a special 
syringe without 
stasis 


increased in uncompensatec 
alkalosis; decreased in 
uncompensated acidosis 


Phenylalanine 


0-3.0 mg./lOO ml. 




increased in certain mental 
diseases 


Phosphatase, 
acid 


0.13-0.63 Sigma u./ 

100 ml. 
0.2-0.8 Bodansky u./ 

100 ml. 
1-4 King- Armstrong 

u./lOO ml. 




increased in cancer of the 
prostate with metastases of 
bone; also in hemolysed 
serum 


Phosphatase, 
alkaline 


0.8-2.3 Sigma u./ 

100 ml. 
1-4 Bodansky u./ 

100 ml. 
3-13 King-Armstrong 

u./lOO ml. 
Child: 2.8-6.7 

Sigma u./lOO ml. 




increased in hyperparathy- 
roidism and in bUiary 
obstruction, rickets 


Phosphorus, 
inorganic 


Adult: 2-4.5 mg./ 

100 ml. 
Child: 4-6.5 mg./ 

100 ml. 




increased in severe 
nephritis and sometimes in 
rickets; decreased in con- 
ditions in which serum 
calcium is elevated 


Phospholipids 


230-300 mg./lOO 
ml. 




important in relation to 
disorders involving fat 
metabolism 



48 THE CANADIAN NURSE 



FEBRUARY 1%f« 



Determination 


Normal Value 


Note 


Clinical Significance 


Potassium 


3.5-5 mEq./l. 


serum must be 


increased in renal failure 






separated from the 


and severe Addison's 






cells within one 


disease; decreased in 






hour 


diabetic coma 


Proteins, adult 






decreased as a result of 


jy electrophoresis 




~ 


marked and prolonged 


total 


6-8 g./lOO ml. 




albuminuria, nephritis, 


Albumin 


3.2-5.6 g./lOO ml. 




liver disease, starvation 


jlobulins 


1.2-3.2 g./lOO ml. 




causing edema; increased 


Alpha 1 


0.1-0.4 g./lOO ml. 




in infections, pneumonia, 


Alpha 2 


0.4-1.2 g./lOO ml. 




multiple myeloma, etc. 


Beta 


0.4-1.0 g./lOO ml. 






Gamma 


0.4-1.5 g./lOO ml. 






Fibrinogen 


0.2-0.5 g./lOO ml. 






Newborn: 








Albumin 


3.3-5.1 g./lOO ml. 






alpha 1 


0.12-0.32 g./lOO ml. 






alpha 2 


0.25-0.47 g./lOO ml. 






beta 


0.17-0.61 g./lOO ml. 






gamma 


0.4-1.41 g./lOO ml. 






1 year: 








Albumin 


4.0-5.0 g./lOO ml. 






alpha 1 


0.15-0.35 g./lOO ml. 






alpha 2 


0.5-1.11 g./100 ml. 






beta 


0.52-0.83 g./lOO ml. 






gamma 


0.45-0.66 g./lOO ml. 






3ver 4 years: 








Albumin 


3.7-5.5 g./lOO ml. 






alpha 1 


0.12-0.3 g./lOO ml. 






alpha 2 


0.35-0.95 g./lOO ml. 






beta 


0.47-0.92 g./lOO ml. 






gamma 


0.53-1.2 g./100 ml. 






•^rotein bound 


4-8 Mg./lOO ml. 




increased in hyper- 


odine (PBI) 






thyroidism 


tiodium 


133-148 mEq./l. 


• 


increased after injudicial 
use of NaCl solution in 
patients with impaired 
kidney function; decreased 
in vomiting, gastrointestinal 
disorders, tube drainage 
(postop), diabetic coma, 
Addison's disease 


Transaminase 


5.40 Ku 




increased in myocardial 


>.G.O.T. 






infarction and infectious 
hepatitis 


Transaminase 


5-35 Ku 




increased in acute hepatitis 


i.G.P.T. 






and relapsing cirrhosis of 
the liver 


Triglycerides 


0-150 mg./lOO ml. 




increased in diseases 
associated with hyper- 
lipemia (diabetes, xanthe- 
matosis, biliary cirrhosis, 
etc.) 


FEBRUARY 1969 






THE CANADIAN NURSE 49 



Determination 


Normal Value 


Note 


Clinical Significance 


Uric acid 


2.5-5.5 mg./lOO ml. 




increased in acute gout, in 
nephritis and leukemia, 
frequently in myelomatosis 



Urine Biochemistry Values 



Determination 


Normal Value 


Specimen Req. 


Note 


Clinical Significance 


Amylase 


60-225 Somogyi 
units/ 100 ml. 


Random 




increased in acute 
pancreatitis 


Calcium 


50-300 mg./ 
24 hr. 


24 hr. 


patient must be 
on special diet 


increased in hyper- 
parathyroidism, 
myelomatosis, etc. 


Catecholamines 


up to 103 Mg./ 
24 hr. 


24 hr. 




increased in adrenal 
medulla tumors 


Chlorides 


170-250 mEq./l. 


Random 




important in con- 
trolling saline 
administration 


Copper 


up to 70 Mg./ 
24 hr. 


24 hr. 


preserve in 

polyethylene 

bottle 


increased in Wilson's 
disease 


Copropor- 
phyrins 


50-300 Mg./ 
24 hr. 


24 hr. 


preserve in 

polyethylene 

botUe 


increased in the 
porphyrias 


Creatine 


0-100 mg./ 
24 hr. 


24 hr. 


preserve in 
toluene 


used in the study of 
muscle diseases 


Creatinine 


0.8-1.5 g./ 
24 hr. 


24 hr. 


preserve in 
toluene 


normally excretion 
constant; altered in 
certain muscle 
diseaases 


Follicle 
Stimulating 
Hormone (F.S.H.) 


before puberty: 

less than 6.5; 

Mouse U./24 hr. 

after puberty: 

6.5-52; 

after menopause: 

96-600 


24 hr. 




important in the 
investigation of 
endocrine 
disturbances 


Estrogens 


ovulatory cycle: 
4-64 Mg./24 hr.; 
normal male: 
4-25 Mg./24 hr.; 
pre-pubertal male 
and female: 
4-25 Mg./24 hr.; 
post-menopausal: 
0-5 Mg./24 hr.; 
pregnancy (3rd 
trimester): 
26-60 mg./24 hr. 


. 24 hr. 


preserve in 
jolyethylene 
jottle, iceep 
cool 


increased in tumors 
of the ovaries; 
decreased in 
ovarian and 
pituitary mal- 
function 


50 THE CANADIAN 


NURSE 









FEBRUARY 1969 



Determination 


Normal Value 


Specimen Req. 


Note 


Clinical Significance 


17 hydroxy- 
corticoids 


female: 5-18 
mg./24 hr. 
male: 8-25 
mg./24 hr. 


24 hr. 


preserve in 
polyethylene 
bottle, keep 
cool 


important in the in- 
vestigation of adrenal 
and testicular 
malfunctions 


5-hydroxy- 
indole- 
acetic acid 
(Serotonin) 


60-160 Mg./ 
24 hr. 


24 hr. 


patient must 
avoid eating 
bananas during 
collection 


increased in 
carcinoid tumors 


17-lceto- 
steroids 


under 10 yr.: 
0-4 mg./24 hr.; 
10-15 yr.: 
3-10 mg./24 hr.; 
Adult female: 
2-17 mg./24 hr.; 
Adult male: 
3-23 mg./24 hr. 


24 hr. 


preserve in 
polyethylene 
bottle, keep 
cool 


important in the 
investigation of 
endocrine 
disturbances 
(adrenal, testes) 


Lead 


0-0.12 mg./24 
hr. 


24 hr. 


preserve in 

polyethylene 

bottle 


increased in lead 
intoxication 


Potassium 


25-100 mEq./l. 


24 hr. 


varies with 
dietary intake 


useful in the study of 
renal and adrenal dis- 
turbance, water and 
acid-base balance 


Pregnanediol 


female: 

3-10 mg./24 hr. 

male: 

0-1.5 mg./24 hr. 


24 hr. 


preserve in 
polyethylene 
bottle, iceep 
cool 


increased in corpus 
luteum cysts and some 
adrenal cortical 
tumors; decreased in 
threatened abortions 


Sodium 


130-260 mEq./l. 


24 hr. 


varies with 
salt intake 


same as potassium 


'Urea 
nitrogen 


8-15 g./24 hr. 


24 hr. 


preserve in 
toluene 


important in the 
investigation of meta- 
bolic disturbances 


Uric acid 


0.4-1.0 g./ 
24 hr. 


24 hr. 


preserve in 
toluene 


useful in the inves- 
tigation of metabolic 
disturbances 


Urobilinogen 


Qualit.: 

Pos. in 1:20 

Quant.: 

0.5-4 mg./24 hr. 


Random or 
24 hr. 


preserve with 
sod. carb. under 
petroleum ether 


increased in liver 
diseases and hemolytic 
jaundice 




C 


erebrospinal F 


luid Values 


Test 




Normal Va 


ue 


Clinical Significance 


Color and 
appearance 


clear 
slight 
needl( 


and colorless; m 
y blood tinged 1 
; trauma; no clc 


ay be 

rom 

t 


cloudy, turbulent or grossly 
purulent in meningitis; bloody 
or yellow when hemorrhage involves 
CNS 


FEBRUARY 1969 












THE CANADIAN NURSE 51 



Test 


Normal Value 


Clinical Significance 


Pressure 


7-15 mm. Hg. (100-200 mm. of 
water), pat. lying down; 
15-22 mm. Hg. (200-300 mm. of 
water), pat. sitting up; 
Child: 3.5-7 mm. Hg. (50-100 
mm. of water), pat. lying down 


increased in meningitis, edema of 
the brain, hemorrhage, neurosyphilis; 
decreased in shock, dehydration and 
spinal canal block 


Cell count 


0-5/cu.mm.; all lymphocytes 


increased in the various types of 
meningitis, poliomyelitis, neuro- 
syphilis and encephalitis; pus cells 
predominate in the acute bacterial 
processes. Increased lymphocytes in 
tuberculous meningitis, poliomyelitis 
and neurosyphilis 


Glucose 


45-80 mg./100 ml. 


increased in diabetes, encephalitis, 
uremia and sometimes in brain tumor. 
Decreased in acute meningitis, tuber- 
culous meningitis and insulin shock. 
Normal values usually found in 
neurosyphilis 


Proteins 


15-40 mg./lOO ml. 


increased in those conditions with an 
increased cell count (see above); 
increased in spinal cord tumor and 
infectious polyneuritis 


Chlorides 


120-130 mEq./l. 


increased in uremia; decreased in 
tuberculous meningitis 


Colloidal Gold 
test 


0000000000 


abnormal forms in meningitis and 
syphilis. Examples; 
555554321000, paretic type curve 
0244310000, leutic or tabetic type 
curve 0000245520, meningitis type 
curve 


Globulin test 
(qualitative) 


neg. 


increased values in all inflammatory 
processes of the CNS 


Bacteriologic 
examination 


neg. 


important in differentiating between 
bacterial, viral, and other causes of 
meningitis 


Serologic tests 
for syphilis 


neg. 


for syphilis 



Blood Bank Values 



Determination 



ABO groups 



Values 



0-45% of population 
A-40% of population 
B-10% of population 
AB-5% of population 



52 THE CANADIAN NURSE 



Clinical Significance 



essential to determine before blood 
transfusion 



FEBRUARY 1969 



Determination 


Values 


Clinical Significance 


iRh groups 


D — Rhpos. 85% of pop. 
d — Rh neg. 15% of pop. 


important in pregnancy. The Rh neg. 
mother with a possible Rh pos. fetus 
might lead to erj'throblastosis fetalis; 
also in persons receiving repeated 
transfusions 


Rh phenotypes 


D causes most difficulties 
in transfusion; others 
(C, E) may cause difficulty 
in crossmatch 


difficulties are picked up in a 
crossmatch; in rare instances no 
crossmatch possible and then blood 
must be given very slowly with close 
observation 


Crossmatch 


match ABO group; in the 
Rh group, D:d 


essential in order to eliminate 
transfusion reaction 


Antibody screen 


screening procedure for 
other Rh phenotypes 


same as Rh phenotypes 


Coombs test 


a test for Rh antibodies 


Rh neg. mother with Rh pos. fetus 
may lead to increased antibody to D. 
Fortunately this can now be eliminated 
by treating mother at parturition with 
high titer anti-D serum 


Cold agglutinins 


when present, these 
agglutinate patitnt's 
red cells 


essential to identify; this can be 
either reversed or weakened by 
warming the blood to 37°C 


Amniotic fluid 
analysis 


test for several chemicals 
(bilirubin, etc.) 


in the Rh mother, tests will show 
whether fetus is Rh neg. or Rh pos. 




Function Tests and Investigations 





Tests 


Principle 


Normal Value 


Clinical Significance 


AC-PC blood 
glucose 


person's ability to 
handle dietary 
carbohydrate 


ac: 70-100 mg./ 

100 ml. 
pc: less than 
150 mg./lOO ml. 


a screening test for 
diabetes mellitus, 
Cushing's syndrome, 
etc. 


Glucose 
tolerance 


a test of ability to 
store and utilize 
dietary carbohydrate. 
The standard test, one 
dose glucose (50 or 
100 g.), blood samples 
1/2 hr., 1 hr., 2 hr.; 
occasionally 4, 5, or 
6 hr. test required 


blood glucose not 
to exceed 150 mg. 
and return to 
normal in 2 hr. 


for diagnosis of 
diabetes mellitus, 
Cushing's syndrome, 
dumping syndrome, 
etc. 


Intravenous 

glucose 
tolerance 


eliminate possibility 
of impaired absorption 
from the intestines 


blood glucose 
returns to normal 
fasting within 
1-1 1/2 hr. 


same as for glucose 
tolerance 



FEBRUARY 1%9 



THE CANADIAN NURSE 53 



Tests 


Principle 


Normal Value 


Clinical Significance 


Insulin 

sensitivity 

test 


test of patient's 
sensitivity to insulin, 
to promote withdrawal 
of glucose from blood 
stream. Dose: 0.25 u./ 
kg. body wt. 


blood glucose 
decreased about 
45 mg./lOO ml. one 
hr. after ingestion 
of glucose with 
insulin then with 
glucose alone 


test for hypopituitarism, 
also useful in Addison's 
disease 


Bromsulphalein 


Bromsulphalein, after 
intravenous injection, 
is excreted almost 
entirely by the liver 


0-7% in 45 min. 


a liver function test 
in patients without 
jaundice 


Cephalin- 
cholesterol 
flocculation 
test 


this test depends upon the 
capacity of the blood 
serum in patients with 
parenchymal liver 
disease to flocculate 
a suspension of cephalin- 
cholesterol emulsion 


neg. and 1 + in 
24 hr. 


increased in hepato- 
cellular and other 
liver disorders 


Galactose 
tolerance 


the liver is the only 
organ which can convert 
galactose to glycogen 
and store it 


less than 3 g. of 
galactose excreted 
in the urine during 
a 5 hr. period 
following ingestion of 
40 g. of galactose 


a liver function test 


Thymol 
flocculation 


an alteration in the 
plasma proteins in 
parenchymal liver 
disease causes pre- 
cipitation of a 
solution of thymol 


ne2. and 1 -|- in 24 
hr." 


a liver function test; 
can be used in patients 
with jaundice 


Thymol 
turbidity 


same as above 


0.2-5.0 units 


more valuable in the 
diagnosis of acute than 
of chronic liver 
disease 


Renal concen- 
tration test, 
diurnal 
variation 


based on the ability of 
the kidney to properly 
concentrate urine 


morning specimen, 
spec, gravity 
1 .023 or higher 


valuable in renal 
diseases, especially 
slowly developing 
chronic diseases 


Mosenthal 
test 


ability of kidney to con- 
centrate urine after a 
test meal 


night spec, not to 
exceed 575 ml.; spec, 
gravity 1.018 and up. 
Spec. grav. in day 
specimens should vary 
by 9 points or more, 
reaching 1.020 in one 
or two specimens 


same as above 


Phenolsulfon- 
pthalein (P.S.P.) 
excretion 


the test is based upon 
the principle that the 
normal kidney rapidly 
and efficiently excretes 
this dye 


30-50% excreted 
in 15 minutes 


principally a test for 
tubular function; 
therefore valuable in 
diseases associated 
with tubular malfunction 


54 THE CANADIAN NURS 


E 







FEBRUARY 1%^ 











Tests 


Principle 


Normal Value 


Clinical Significance 


P.S.P. 

fractional 


same as above 


60% and over in 
2 hr. 


same as above 


Creatinine 
clearance 


measure rate of 
elimination of creatinine 
by the kidney 


90 ml. and over/ 
min. 


this is a test for 
glomerular function. 
Important in diseases 
associated with glome- 
rular malfunction 


Inulin 
clearance 


inulin is excreted only by 
glomerular filtration; the 
test is a measure of rate 
of excretion of intra- 
venously administered 
inulin 


the amount of 
inulin contained 
in 100-150 ml. of 
plasma excreted 
per min. 


a more specific test 
than creatinine 
clearance 


Urea 
clearance 


a measure of the rate of 
elimination of urea by 
the kidney 


60-95 ml. of 
blood/min. 


urea is filtered by the 
glomerules and part re- 
absorbed by the tubules. 
It, therefore, is of 
limited value in 
diseases of the kidney 


GI absorption 
test with 
triolein 

131J 


triolein is administered 
by mouth; it is digested 
in the GI tract by pan- 
creatic lipase and 
absorption facilitated 
by bile 


8% and over in 
the 4th, 5th and 
6th hr. 


a test for malfunction 
of bile and pancreas. 
Therefore, important 
in diseases of the 
liver and pancreas 


GI absorption 
with oleic 
acid 1311 


oleic acid is given by 
mouth and absorption 
requires the presence 
of bile 


same as above 


a test for normal pro- 
duction and secretion 
of bile; therefore, 
useful in diseases of 
the liver, and, with 
triolein, eliminates 
diseases of the pancreas 


Xylose 
tolerance 


xylose, a pentose sugar, 
is absorbed from the 
intestine by diffusion 
and not metabolised; 
xylose dose given by 
mouth 


1 hr.: 29-49 
mg./lOO ml.; 

2 hr.: 20-60 
5 hr.: 8-16 
5 hr.: urine 
xylose: 4-8 g. 


a useful test for 
gastrointestinal 
absorption in 
absence of renal 
disease 


ACTH 

stimulation 


ACTH hormone stimulates 
the adrenal cortex to 
secrete corticosteroids 


increase of 8-16 
mg./day of 17- 
hydroxycorticoids; 
increase of 4-8 mg./ 
day of 17-keto- 
steroids 


very useful to 
differentiate diseases 
of the pituitary and of 
the adrenal cortex 
(Cushing's syndrome, 
etc.) 


Congo Red 


amyloid tissue has con- 
siderable selective 
affinity for Congo Red. 
The dye is injected 
intravenously and con- 
centration measured 
serially in blood 


35% or less 
retention 


valuable in the 
differential diagnosis 
of amyloid disease, 
primary and secondary 



FEBRUARY 1%9 



THE CANADIAN NURSE 55 



Tests 


Principle 


Normal Value 


Clinical Significance 


Gastric 
function 


measure of acidity of 
fasting gastric con- 
tents and serial 
samples after a test 
meal (with or without 
histamine) 


fasting residual 
5-100 ml.; after 
test meal 30-300 
ml. first hour; 
titratable HCl 
Female: 0-25 
mEq./l./hr. 
Male: 0-48 
mEq./l./hr. 


valuable test in 
diseases of the 
stomach 


Maximal 
histamine 
gastric 
secretion 


this is a modification 
of above and must be 
carried out with great 
care. The patient is 
given a large dose of 
antihistamine followed 
by a large dose of 
histamine. The prin- 
ciple is to create 
maximum response of 
the stomach 


Female basal: 
0.5-2 mEq./l. 
post-histamine: 
10-24 mEq./l. 
Mak basal: 
1-3 mEq./l. 
post-histamine: 
10-30 mEq./l. 


same as above 


The LE test 
(Paratoluene 
sulphonic 
acid test) 


in certain diseases 
abnormal granulocytes 
appear in the blood 
containing a large amount 
of nuclear material 


neg. 


positive results are in 
lupus erythematosis, 
liver disease, myeloma- 
tosis, and occasionally 
rheumatoid arthritis 


Sweat test 


in certain diseases of 
the pancreas there is 
excess secretion of 
sodium chloride in 
the sweat 


sodium 10-80 
mEq./l. 
chloride 4-60 
mEq./l. 


increased sodium and 
chloride in the sweat 
in fibrocystic diseases 
of the pancreas 
(mucoviscidosis) 


Fecal fat 


most dietary fat is 
digested and absorbed; 
increase in fecal fat is, 
therefore, significant 


1-7 g./24 hr. 
7-25% (dry 
weight) 


increased amount in 
sprue, steatorrhea, 
etc. 


Fecal 
bacteriology 


to establish presence of 
abnormal bacteria in GI 
tract; specimen must 
be fresh 


reported as "normal 
flora" and any 
abnormal organisms 


differential diagnosis 
in diseases associated 
with diarrhea 


Fecal mycology 


to verify presence of 
ameba, etc. in GI tract; 
specimen must be fresh 


presence of ova or 
spores reported 


same as above 



56 THE CANADIAN NURSE 



FEBRUARY 196?" 



student observation 
at postmortem examinations 



Is observation of postmortem examinations helpful in supplementing a nursing 
student's knowledge of anatomy, physiology, and pathology? How many 
schools of nursing in Canada encourage their students to attend these 
examinations? THE CANADIAN NURSE sent questionnaires to the educational 
directors of 154 English-language schools of nursing in Canada to attempt 
to answer these questions. 



V.A. Lindabury 

The question of whether nursing stu- 
dents should be encouraged — or even 
allowed — to attend postmortem exami- 
nations as part of their clinical experience 
has long been debated by nurse educa 
tors. In conversation and in writing, 
most educators reveal strong feeUngs 
either in favor of or against the inclusion 
of this experience in the nursing curricu- 
lum. 

Frequently the response of nurse 
educators is colored by their own re- 
actions to autopsies they attended when 
they were students. As one respondent 
wrote, "I found this a most distasteful 
experience when 1 was a student. Because 
of this, I discourage my students from 
attending postmortems . . . ." 

Questionnaire 

One hundred and fifty-four question- 
naires were sent to English-language 
schools of nursing. The first question 
asked respondents to check one of the 
following to indicate their school's policy 
on student observation of autopsies: (a) it 
is compulsory for each student to attend 
a given number of postmortem exami- 
nations; or (b) it is not compulsory, but 
students may attend at their own request, 
if the instructor considers it a worthwhile 
educational experience; or (c) students 
are not allowed to attend postmortem 
examinations. The respondents were then 
asked to explain their reasons for the 

Miss Lindabury is Editor of the canadun 
NimsE . She acknowledges with thanks the 
assistance of the 1 35 educational diiectois who 
responded to this questionnaire. 



FEBRUARY 1%9 



policy they had checked. 

The remaining questions were directed 
to those respondents who had checked 
(a) or (b) above. These respondents were 
asked if instruction were given to the 
students during the autopsy and, if it 
were, by whom. They were also asked to 
indicate whether students are required to 
submit a written report following their 
observation. 

The final question asked the nurse 
educators to indicate how nursing stu- 
dents react to their observations of an 
autopsy. For example, do students find 
this experience helpful? In what way? 
Are they upset by this observation? 

Results of first question 

One hundred and thirty-five of the 
154 questionnaires sent out were return- 
ed, a response rate of 87.6 percent. Of 
these, 6 respondents (4.4 percent) stated 
that their schools had no policy con- 
cerning student observation at post- 
mortem examinations: two gave no 
reason for the absence of a policy, and 
four stated that the school's faculty was 
still in the process of constructing the 
curriculum. 

Three respondents (2.2 percent) said 
that it was compulsory for students to 
attend a given number of postmortem 
examinations during their educational 
program. Ninety-two respondents (68.1 
percent) said it was not compulsory for 
students to attend these examinations, 
but that students could attend at their 
own request if the instructor considered 
it a worthwhile educational experience. 
Thirty-four respondents (25.2 percent) 

THE CANADIAN NURSE 57 



stated that students were not allowed to 
attend autopsies. 

Reasons given 

The three respondents who said that 
student observation of a postmortem 
examination was compulsory in their 
schools gave almost identical reasons for 
this pohcy. They looked on this experi- 
ence as helpful to the student in her 
learning of anatomy, physiology, and 
pathology. One respondent added that 
the experience ". . . assists [students] in 
interpreting the purpose and process of 
this examination to many various indi- 
viduals." 

The 92 respondents who were against 
compulsory observation, but who allowed 
it if requested by the student with the 
instructor's permission, gave similar, but 
more detailed reasons. One respondent 
pointed out that students ". . . receive 
only two weeks observation in the oper- 
ating room, and therefore do not see as 
much human body structure as we would 
like." This respondent believed that 
observation of an autopsy was a necessary 
supplement to the student's under- 
standing of body structure and the 
disease process. 

Nine (9.8 percent) of these 92 res- 
pondents who allowed their students to 
observe autopsies had misgivings about it. 
These respondents said that most of the 
faculty did not consider this type of 
observation to be a worthwhile experi- 
ence for students; however, because the 
faculty believed students should be given 
the opportunity to be self-directing, they 
permitted the student to attend at least 
one autopsy if she requested it. 

Of the 34 respondents who said that 
observation of autopsies was not included 
as part of the learning experience, five 
gave no particular reason. Eight reported 
inadequate facilities, which prevent 
students from attending postmortem ex- 
aminations; one said that autopsies are 
not performed in the hospital where the 
school is located; and one said, "as a 
regional school, we are independent of 
any hospital . . . . " Two respondents said 
that observation of an autopsy serves 
only to satisfy "morbid curiosity"; an- 
other said that the pathologist is reluctant 
to have nursing students attend an autop- 
sy. Two other respondents said that the 

58 THE CANADIAN NURSE 



experience was too "traumatic" and 
"shattering" to be of any educational 
value to the student. The remainder 
questioned the value of such an experi- 
ence and pointed out that the school's 
objective was to increase interest in 
nursing care, not in the pathology of 
disease. 

One respondent summed up her facul- 
ty's reasons in this way: 

"The traditional reason for permitting 
students to view autopsies is to clarify 
and otherwise augment their study of 
anatomy. The reason for performing an 
autopsy is not to teach students, but to 
determine the cause of death. We do not 
believe that these two complement each 
other too well. Although it is a recog- 
nized method of study and research for 
medical students, we do not believe it to 
be a valid or necessary educational tool 
by which to teach student nurses gross 
anatomy. 

"The potentially negative variables are 
these: 1. The age of the student: the age 
of the patient (child, adolescent, infant, 
etc.); 2. The extent of the autopsy: 
[examination of] the cranium is usually 
very upsetting . . . . ; 3. The attitudes and 
techniques of the pathologist: the majori- 
ty are positive, professional, and gentle — 
but there are others to whom no student 
nurse should be exposed. 

"If the student has been caring for the 
patient prior to his or her death, the 
experience is sobering enough for the 
average student without subjecting her to 
the sequel of a postmortem. The cause of 
death can be ascertained later from the 
doctor, head nurse, or medical-records 
department. 

"If the student has not been caring for 
the patient, the viewing of the post- 
mortem is irrelevant . . . . " 

Instruction during autopsy 

Of the 95 respondents whose students 
view autopsies (3 respondents reported 
compulsory observation; 92 reported that 
students are allowed to view autopsies, 
although it is not a compulsory experi- 
ence), 70 said that the autopsy is ex- 
plained to the student by the pathologist, 
in 20 instances, explanation during the 
autopsy is apparently given by both the 
pathologist and the instructor. Five of the 
95 respondents did not answer this 
section of the questionnaire. 



Twelve respondents reported that a 
conference with the students is held by 
the instructor prior to the observation. 
Seventeen respondents said that a group 
discussion with the instructor was held 
following the autopsy. Only four res- 
pondents said that students were required 
to submit written reports of their obser- 
vations. 

Student reactions 

Most of the 95 nurse educators who 
responded to this question believe that 
students find the observation of a post- 
mortem examination of some assistance 
in understanding anatomy and the disease 
process. Almost every respondent added, 
however, that some students do find the 
experience upsetting. Two respondents 
said that careful preparation of the stu- 
dent, similar to the preparation given for 
other types of clinical experience, helped 
to minimize any adverse emotional re- 
action. One respondent said, "Students 
seem to be able to look on [the post- 
mortem examination] as an objective 
learning experience after they have over- 
come their initial distaste." 

More than one respondent noted that 
students are often upset by the sound ol 
the bone cutter; other respondents saic 
that students are more likely to be upsei 
when they had previously nursed th£ 
patient on whom the autopsy was beinj 
performed. 

Twenty of the 95 respondents whi 
indicated that their students observ 
autopsies stressed the importance of th 
attitude of the pathologist who teachei 
the students. They believe the manner ii< 
which the pathologist conducts thx 
autopsy influences students' reaction t' 
the procedure, and determines whether i 
is a true learning experience. As on 
respondent said, "The attitude of th i 
pathologist is of utmost importance 
preserving the dignity most student 
accord the human being." 

Although most nursing students aji 
parently find the observation of autopsicf 
helpful, some of them are left witi 
conflicting feelings. Three responden 
said that several students expressed thv 
view that they would not allow an autO'i 
sy to be performed on a member of thei 
family, even though they recognized thi 
value of a postmortem examination. 

FEBRUARY 1! 



Nursing organization — 
circa 1969 

The time has come to change the traditional organization of nursing service. 
What better time could there be to put fresh ideas to the test than when a brand 
new hospital is being planned ? 



"Traditional patterns of nursing organ- 
ation have served the past well, but they 
mnot cope with the complexities of 
lodern nursing service." This was the 
oinion held by the nurses involved in 
anning the University Hospital, a new 
aching hospital to be located on the 
impus of The University of Western On- 
rio in London. 

The 434-bed hospital is scheduled for 
)mpletion in the (all of 1971. It will be 
le final stage in the development of The 
niversity of Western Ontario's Health 
:iences Centre. The complex will in- 
ude, under one roof, the Kresge School 
' Nursing building, the Cancer Research 
aboratory, the Medical Sciences 
iilding, and the Dental Sciences build- 
g. The University Hospital will contain 
cilities for a school of medical re- 
ibilitation. 

The director of nursing. University 
ospital, a permanent member of the 
3spital planning group, and faculty 
embers of the school of nursing at The 
niversity of Western Ontario have been 
osely involved in all phases of planning 
e University Hospital. Working with the 
edical faculty, architects, and planning 
oup members, the nurses have ensured 
at the new hospital will serve the three 
'incipal functions of a university 
)spital - teaching, research, and service 

patients. 

Definite ideas about how the depart- 
ent of nursing should be organized have 
rmed the basis of the planners' design 
the patient-care areas. Form has 
llowed function in the planning of the 
itire hospital. 

<*»BRUARY 1%9 



Diane Y. Stewart, M.Sc.N. 

The hospital will be a 10-story struc- 
ture. The base, consisting of basement 
and three floors, contains mainly services 
for the hospital. Superimposed on the 
base are two connected seven-story 
towers. On each floor one tower contains 
two 30-bed inpatient units and related 
teaching facilities; the other tower 
contains offices for clinical department 
heads and their associates, research 
laboratories, and an outpatient depart- 
ment. Between the two towers is a bank 
of elevators and facilities for handling the 
service requirements of the entire floor. 

Authority decentralized 

When planning the organization of the 
department of nursing, the following two 
principles were considered: first, 
authority should be decentralized from 
the director of nursing to other nursing 
staff, and second, nurses should be 
relieved of non-nursing functions. 

Decentralization of authority, that is 
delegating decision-making to lower levels 
in the organization, has been an im- 
portant management principle in industry 
for over 20 years. Naturally, decentral- 
ization of authority is a matter of degree, 
as basic decisions and policies must 
receive attention at top levels.* 

Miss Stewart is a graduate of the Victoria 
Hospital in London, Ontario and received her 
master's degree in nursing service adminis- 
tratiop from The University of Western 
Ontario. She is Director of Nursing at the 
proposed University Hospital in London and 
part-time Associate Professor of Nursing at The 
University of Western Ontario. 



In most nursing service departments 
this concept has been overlooked; nursing 
office supervisors are centrally located 
and are responsible for most decisions. A 
decentralized system would relocate 
supervisors in their area of clinical 
interest where they would work directly 
with head nurses and staff and be 
responsible on a 24-hour basis for organ- 
izing, directing, and coordinating nursing 
functions. In this way, the supervisor 
would be given the authority and respon- 
sibility she should have but would have 
considerable latitude in exercising in- 
dependent judgment and initiative. 

With decentralization of authority the 
head nurse would be granted increased 
responsibility for decision-making and 
planning and coordinating patient care. 
There would be more involvement of 
team leaders and staff nurses in the 
decision-making process. Nurses have 
repeatedly said that they want to have, 
and should have, more responsibility. 
With this structure, they should receive 
the additional responsibility and so find 
the work situation much more satisfying. 

The director of nursing at University 
Hospital will be directly responsible to 
the executive director for directing and 
coordinating the nursing care of all pa- 
tients, providing inservice education for 
nursing personnel, and directing a 
program of nursing research in tlie 
hospital. 

Three nurses will be directly respon- 

*Massie, Joseph L. Essentials of Management. 
Englewood CUffs, N.J., Prentice-Hall Inc., 
1964, pp.51-52. 

THE CANADIAN NURSE 59 




T O \V E 12 



60 THE CANADIAN NURSE 



FEBRUARY 1969 



sible to the director of nursing: 

• The associate director of nursing 
will be responsible for the overall 
direction and coordination of nursing 
care of patients in all patient-care areas. 

• The administrator of nursing 
education will direct educational 
activities related to nursing in the hospital 
and maintain liaison with the University 
School of Nursing regarding clinical ex- 
perience for nursing students, and 
refresher and postgraduate specialty 
courses for registered nurses. 

• The administrator of mirsing 
research will be responsible for the re- 
search program related to nursing in the 
hospital. She will cooperate with the 
nursing staff to identify areas requiring 
study, and plan and implement programs 
of nursing research. She will cooperate 
closely with the faculty of the school of 
nursing to coordinate research projects 
and studies, to share facilities and results, 
and to avoid duplication. 

These three nurses and the director of 
'nursing will be the only nursing staff 
occupying offices in the central nursing 
administration suite. The remainder of 
the senior nursing staff will be located on 
the nursing floors. 

Traditional roles changed 

This structure involves a change in the 
traditional roles of both the supervisor 
and head nurse. For this reason, the titles 
nursing administrator and nursing coordi- 
nator were considered more appropriate 
and meaningful. 

A nursing administrator will be located 
on each of the patient-care floors. Each 
floor will represent a different service or 
combination of services. The nursing ad- 
ministrator will be a specialist in her 
clinical area as well as an administrator. 
She will be responsible over a 24-hour 
period, for all inpatient and outpatient 
nursing activities on her 60-bed floor. At 
this level - close to the patient - many 
decisions will be made wliich, in the past, 
have been made by supervisors in a 
central nursing office. There will be no 
central nursing office supervisors. 

Working with the nursing adminis- 
FEBRUARY 1%9 



trator on a floor will be two nursing 
coordinators, one for each 30-bed unit. 
Th'ese nursing coordinators, also 
specialists in their clinical area, will be 
responsible for the nursing activities on 
their unit. They will organize their staff 
into teams of graduate nurses, registered 
nursing assistants, and nursing orderlies, 
with graduate nurses as team leaders on a 
rotation basis. It is hoped that in the 
future, nursing orderlies will become 
registered nursing assistants. 

The nurse clinician or clinical specialist 
concept is both creative and challenging. 
However, nurses prepared at the master's 
level are in short supply, particularly 
those prepared in a clinical specialty. In 
the University Hospital nurses will be 
relieved of non-nursing functions and, 
therefore, should have much more time 
to spend with the patients. Consequently, 
the nursing administrator and nursing 
coordinator, both prepared in a clinical as 
well as a functional specialty, will have a 
dual role, but will spend most of their 
time with staff and patients. This seems 
to be the most economical and realistic 
approach to take at this time and should 
provide a role for senior nursing staff that 
affords much job satisfaction. 

Floor managers 

Over the years, as patient care has 
become more elaborate and extensive, 
nurses have assumed responsibility for 
many functions that they have neither 
the preparation nor the time to perform. 
To relieve nurses of this myriad of non- 
nursing functions, the floor manager 
concept has been proposed for the 
University Hospital. 

One floor manager, responsible to the 
hospital administration, will be located 
on each floor. His work will involve the 
entire floor of inpatient and outpatient 
areas, as well as teaching and research 
areas. The floor manager will be expected 
to coordinate efficiently the various 
hospital services and functions that do 
not have to be performed by staff re- 
sponsible for the direct care of patients. 
He will be responsible for non-nursing 
functions such as duties related to equip- 



ment, supplies, linen, house-keeping, 
clerical work, maintenance and portering. 

The employment of floor managers 
should allow nurses to spend more time 
with patients. Ultimately, there should be 
an improved quality of patient care, a 
lower turnover of nursing staff, a higher 
staff morale, and increased job satis- 
faction. 

By decentralizing authority in nursing 
service and employing floor managers, 
each floor in the University Hospital 
should function to a large extent au- 
tonomously. A cooperative relationship 
among the clinical department head or his 
deputy, the nursing administrator, and 
the floor manager should provide 
adequate care and treatment of patients 
on each floor over a 24-hour period. 

The service departments will also be 
organized in a way that will help ease 
pressures placed in the past on nursing 
staff. The dietary department will have 
complete responsibility for all food 
services. The pharmacy department will 
assume full responsibility for the pro- 
vision of total pharmaceutical services in 
the hospital, such as the centralized unit- 
dose medication system, clinical pharma- 
cists, intravenous solution admixture pro- 
gram, and automatic replenishment of 
controlled drugs. The central processing 
department will be responsible for 
providing an adequate complement of 
linen, equipment, and supplies to all in- 
patient and outpatient areas, operating 
and delivery rooms, and research labora- 
tories. Linen and supplies in patient-care 
areas will be delivered directly to nurse 
servers in the patients' rooms. These, as 
well as other improvements, sliould 
certainly allow nursing staff to spend 
more time with patients. 

The future 

In the University Hospital nurses are 
attempting to meet the demands placed 
on nursing service today by anticipating 
the needs of tomorrow. 

This is not a simple chore, but to 
accept the restrictions of a traditional 
nursing organizational structure would be 
sheer regression! D 

THE CANADIAN NURSE 61 



Two-year versus 
three-year programs 

Do graduates of a two-year hospital nursing program compare favorably with 
graduates of a three-year program? This is a vital question for nursing at this time. 
This study reveals some unexpected observations. 



In 1962 the Regina Grey Nuns' 
Hospital introduced a two-year nursing 
education program on an experimental 
basis. It was introduced on the hypothesis 
that if repetitions were eliminated in 
classes and learning experiences were 
carefully selected and well-guided, the 
student could become a competent nurse 
in less than three years. 

The three-year nursing education 
program was not discontinued when the 
experimental two-year program was intro- 
duced. To evaluate the respective merit of 
the two- and three-year programs, a group 
of students in each program was selected 
for comparison. 

In 1962 and 1963, 20 nurses were 
assigned to the experimental program and 
in each year 20 matched controls were 
assigned to the three-year nursing 
program. The two groups were matched 
on age, father's occupation, abstract and 
verbal reasoning ability, science aptitude, 
reading ability, and personality variables 
such as need to achieve, need for change 
in environment, ability to endure, sense 
of responsibility, emotional maturity, 
and self-sufficiency. The matching was 
done on the basis of measurements from 
well-established psychological tests. 

In addition to the 40 subjects chosen 
in 1962 and the 40 selected in 1963, 
three matched groups of special control 
students were selected from the 1961, 
1962, and 1963 classes. 

These three matched groups were se- 
lected for the purpose of determining 
whether the two raters who were to rate 
the performance of the nurses on the 
ward changed their standards in any way 
62 THE CANADIAN NURSE 



C.G. Costello and Sister T. Castonguay 

over the years. Such a change would have 
made it difficult to interpret the findings 
from the experimental and control 
groups. No change in the standard of 
raters was found to have occurred. 

Both the experimental and the control 
students followed a program in which 
repetitions in classes were eliminated, 
content was enriched, and concurrent 
teaching was introduced. A detailed 
account of the changes in the curriculum 
is found in the complete report. 

Ratings were made by independent 
raters from outside the hospital who did 
not know to which group the new gradu- 
ates belonged; and special control groups 
were set up so that the effects of the 
repeated use of the rating scales could be 
determined. 



Dr. Costello is ] Professor of Psychology at 
the University of Calgary. Sister Castonguay 
was Superintendent of Nursing Education, 
Dept. of Education, Province of Saskatchewan,, 
at the time the article was written. 

The analysis of the data obtained in this 
project was done in 1968 with the assistance of 
a Canadian Public Health Research Grant no. 
608-7-116, and thanks are due to the Alberta 
Department of Public Health for their approval 
of the grant. Thanks are due also to the Saskat- 
chewan Department of Public Health for their 
approval of the expenses incurred in the con- 
ducting of the experimental program. A more 
detailed account of this study may be obtained 
by writing to Mrs. CO. O'Shaugnessy, Director, 
School of Nursing, Regina Grey Nuns' Hospital, 
Regina Saskatchewan. 



Other evaluations 

Other evaluations of two-year pro- 
grams have been carried out and, on the 
whole, these evaluations have shown that 
graduates from two-year programs com- 
pare favorably with graduates from 
three-year programs. However, all these 
evaluation studies have suffered from seri- 
ous methodological faults. For instance, 
Lord (1962) presented a report on the 
evaluation of an experimental program es- 
tablished in Windsor, Ontario, in 1948. 
Directors of nursing and physicians who 
observed the nurses at work were asked 
to rate them in relation to dependability, 
knowledge of nursing theory, knowledge 
of nursing practice, attitude to super- 
vision, attitude to patients, all-round a- 
bility, and capacity for growth. It was 
found that, in the opinion of the di- 
rectors of nursing, 48.3 percent, and in 
the opinion of the doctors, 40.5 percent 
of the experimental program graduates 
were rated better than "other nurses." 
The director of nursing also rated 50.3 
percent of the experimental graduates as 
"about equal" to other nurses and the 
physicians considered 61 percent of the 
experimental graduates to be in this cate- 
gory. 

Unfortunately, there were no control 
students with which one could compare 
the experimental graduates. Three "con- 
trol" schools were selected in a manner 
not identified in the report; two were 
from Ontario and one was from Saskat- 
chewan. Unfortunately, these control 
schools were used only for comparison of 
data concerning students' enrolment and 
curriculum and not for comparison of the 

FEBRUARY 1969 



relative nursing skills of graduates from 
the program. A further problem lies in 
the vagueness of some of the dimensions 
in which the ratings were to be done; for 
instance "capacity for growth." Perhaps 
even more serious is the fact that the 
physicians and nurses doing the ratings 
were aware of the fact that the graduates 
were from an experimental program; thus 
the important single-blind condition was 
not met. The single-blind condition means 
that raters are aware of the particular 
educational program or other experience 
to which the people being rated have 
been subject. This is absolutely essential 
if rater bias is to be avoided. 

Similar kinds of criticisms can be made 
of the studies that have been presented 
by Schmitt (1957), Mussallem (1959), 
Gotkin (1956), Gallagher (1956), the 
Glasgow Royal Infirmary (1963), Montag 
(1959), and Spaney and her colleagues 
(1962). 

Specific skills rated 

To evaluate the experimental and con- 
trol nurses at Regina Grey Nuns' Hospi- 
tal, the following measuring devices were 
used: 

1 . A scale for the rating of nurses by 
senior nurses: This was a list of 195 
critical incidents related to nursing per- 
formance, based on a list developed by 
Gorham (1962). Each incident was a de- 
scription of a specific aspect of nursing 
behavior. Some examples are: "explains 
ongoing procedures to patients"; "cor- 
rects safety hazards in environment"; 
"double checks medical orders." Such 
lists of critical incidents are generally con- 
sidered more reliable than the usual rating 
scales using abstract concepts such as "is 
responsible," "is honest," "is consci- 
entious," and so on. This 195-item scale 
was used to rate the nurses by two inde- 
pendent raters not employed at the Grey 
Nuns' hospital, who observed the nurses 
for a period of five days.* The nurses 
were observed on the ward and an en- 
deavor was made to vary the ward 
experience in a similar way for all the 
students. All the students wore the same 
bands on their nursing caps, so that the 

*We wish to thank our two independent 
raters, Mrs. Agnes Gunn and Miss Florence 
Roach, for their assistance. 
FEBRUARY 1%9 



group to which they belonged was un- 
known to the rater. 

2. Evaluation of students in a simu- 
lated nursing situation: The students were 
taken individually into the nursing labora- 
tory. Nursing equipment was available 
and other students played the role of 
patients. Each student was given, in suc- 
cession, three descriptions of a nursing 
situation; each situation was selected at 
random from one of three groups of 
situations so that each student had one 
difficult, one intermediate, and one easy 
situation.** The students were observed 
by two supervising nurses at the Grey 
Nuns' Hospital. These two supervising 
nurses independently checked whether or 
not certain required behaviors occurred 
and also the time taken to carry out the 
particular nursing procedure. 

3. The scores on the State Board 
Test Pool Examination, the School of 
Nursing Examinations, and the National 
League of Nursing Achievement Tests 
were analyzed. 

4. Self-evaluations were made by the 
students and evaluations were made by 
their employers after three months and 
again after one year following graduation. 

5. Because it was feared that the ex- 
perimental students during their edu- 
cation might get preferable treatment 
because they were experimental students, 
some check on this was required. To do 
this, the students in both the experi- 
mental and the control groups were asked 
to evaluate their supervisors using a list of 
critical incidents. The students were also 
asked by the use of a technique known as 
the semantic differential to indicate their 
attitude to things like the hospital, their 
supervisors, and the physicians. 

Unexpected results 

When any student withdrew from the 

**Examples of the situations are: 1. Your 
patient has asthma. She has been dyspneic 
during the night and the doctor has ordered 
oxygen by nasal catheter. Please administer 
nasal oxygen. 2. Mrs. Brown has had a perineal 
repair five days ago. You are to give her peri- 
neal care. 3. Mrs. Jones has just had a complete 
bed bath. You are assigned to make her occu- 
pied bed. She is a 47-yeai-old housewife hospi- 
talized with chronic anemia. 



school, whether she were an experimental 
or a control student, her matched student 
also had to be withdrawn from the ex- 
periment to keep the two groups 
matched. As a result, some of the com- 
parisons between the experimental and 
the control group are made on only 24 
pairs rather than 40 pairs of students. It 
should be remembered, however, that the 
statistical procedures used account for 
this reduced number of pairs so that the 
significance of the results is not altered in 
any way. 

As noted previously, by analyzing 
separately the data on the 1961, 1962, 
and 1963 special control groups, it was 
found that the two outside raters did not 
change significantly in their use of the 
rating scales. Despite the fact that specific 
behaviors were being rated, the two raters 
did differ from one another to quite an 
extent however, so that the data for the 
experimental and control students were 
analyzed separately for the two raters. In 
both analyses, the control students, that 
is the three-year students, obtained a 
higher score for their behavior on the 
ward. In the case of one of the raters, this 
difference in favor of the control students 
was highly significant. 

The two observers in the simulated 
nursing situation agreed almost com- 
pletely; therefore their observations were 
combined. The three-year control stu- 
dents did better than the two-year experi- 
mental students in all three types of 
nursing situation: the easy, the inter- 
mediate, and the difficult. However, the 
difference in favor of the control students 
was only significant for one of the levels 
— the intermediate. The control students 
also performed the task more quickly 
than the experimental students; in two 
levels — the easy and the difficult — the 
difference in favor of the control students 
was significant. 

In the State Board examinations, the 
control students obtained a higher mean 
mark than the experimental students but 
only the difference in child nursing was 
significant. On the School of Nursing ex- 
aminations control students got better 
marks than the experimental students in 
every section but one (surgical nursing). 
in two sections (obstetrical nursing and 
psychiatric nursing) the differences were 

THE CANADIAN NURSE 63 



significant, although psychiatric nursing 
was not written by all control students. 
In the National League of Nursing exami- 
nations, the control students did better 
than the experimental students in all 
sections except one (medical) but none of 
the differences were statistically signifi- 
cant. 

Thirty-nine head nurses were asked to 
indicate the score they felt a graduate 
nurse should get on each of the following 
ten aspects of nursing: application of 
nursing principles, nursing judgment, 
conscientiousness, human relations, 
organizational ability, observational abil- 
ity reaction under pressure, communi- 
cation skills, objectivity, flexibility. 

In their first evaluation, three months 
after graduation, the control group 
obtained a higher mean rating in each of 
the ten parts. In three parts - communi- 
cation skills, objectivity, and flexibility - 
the difference in favor of the control 
group was significant. The experimental 
group scored significantly higher than 
head nurses' expectations in their re- 
action under pressure, but were signifi- 
cantly lower in their communication 
skills and objectivity. The control group 
was significantly hi^er than head nurses' 
expectafion in their nursing judgment, 
organizational ability, reaction under 
pressure, and flexibility. 

In the second evaluation, taken 12 
months after graduation, a shortened list 
of critical incidents related to ward be- 
havior was used; again, the control group 
did significantly better than the experi- 
mental students. 

The two- and three-year nurses did not 
differ in their attitudes to the supervising 
nurses and the hospital situation in gener- 
al, suggesting that neither group had had 
preferential treatment. 

Conclusive evidence 

This study provides conclusive evi- 
dence that the students in this three-year 
program performed better generally than 
students in the two-year program. To 
what extent this is due to the difference 
in the length of the program cannot be 
determined precisely because the length 
of the program is confounded to some 
extent with other differences, such as cur- 
riculum differences. 

However, in view of the systematic 
and objective method of evaluation used 
in this study, the conclusions reached by 
the observers must be seriously con- 
sidered. This meticulous method of 
evaluation may be summarized as 
follows: 

1. The experimental and control 
groups did not differ initially on any of 
tlie matching variables; therefore, any 
differences found between them on the 
dependent variables can with some con- 
fidence be attributed to the effects of the 
different programs. 

2. The two external raters did not 

64 THE CANADIAN NURSE 



show any systematic change in their 
ratings over time; this was indicated by 
the lack of significant differences in the 
ratings obtained by the students in the 
three matched special control groups. 
Therefore, the difference in the rafings by 
the external examiners can be relied on 
with some confidence. 

3. The control students did better 
when rated for their ward performance 
by external raters. 

4. The three-year students showed 
more of the expected behaviors and per- 
formed them more quickly in a simulated 
nursing situation. 

5. In the three written examinations - 
State Board examinations. School of 
Nursing examinations, and National 
League of Nursing examinations - the 
control students did better than the ex- 
perimental students. 

6. The control students obtained 
better scores in employers' evaluations 
both three months and 12 months follow- 
ing termination of the course. 

7. The scale for evaluating supervising 
nurses and the semantic differenfial was 
included in the study because it was fear- 
ed that during the course the nursing 
school faculty might have had a better 
attitude toward the experimental stu- 
dents. These instruments were designed 
to detect any differences of this sort. 
However, the results from the scale for 
evaluating supervising nurses indicated no 
differences between the two groups in 
their perception of supervising nurses. 
There was one significant difference on 
the semantic differential but, as has been 
suggested, because of the multiple com- 
parisons that were made, no great reliance 
can be put on this. 

Interpret results carefully 

The contrast in the results obtained by 
this systematic and objective evaluation 
study and those of more subjective and 
less well controlled studies is obvious. 
The results of this study are much less 
favorable for two-year programs than the 
other studies to which we have referred. 

The results of this study, however, 
must be interpreted with care and used 
with equal care as the basis for practical 
decision-making. 

Some readers may very well feel — and 
with justification — that though the con- 
trol groups have done generally better 
than the experimental students, the 
difference in favor of the controls is not 
so marked as to justify an extra year of 
education. With some modification of the 
two-year program, the difference in favor 
of the three-year program may disappear 
and, indeed, the findings may be com- 
pletely reversed. It is also important to 
keep in mind that since the experimental 
students generally met the head nurses' 
expectations and the registration re- 
quirements, one can with confidence go 
along with the educational trend of 



"saving one year" of the student's time. 

The very fact that the experimental 
students were experimental may have put 
them under greater stress or pushed their 
drive level beyond an optimum level. It is 
a well established fact in psychology that 
too high a drive level will result in deteri- 
oration in performance, particularly with 
complicated tasks (such as nursing) and in 
the case of relatively inexperienced 
people (such as new graduates of 
nursing). 

It is not our intention to resort to 
special pleading. It is true that the find- 
ings in favor of the controls, though not 
overwhelming, were unexpected. By this 
time, however, several other classes have 
been admitted to the program and im- 
portant changes have been introduced in 
the curriculum. It would be most inter- 
esting to make an evaluation of the 
program as it is offered in 1968, six years 
after its first introduction into the school. 

Bibliography 

Gallagher, Anna G. Descriptive study of a 
twenty-six month program for the basic 
preparation of nurses. Philadelphia, 1965. 
(Thesis (Ed.D.) - University of Pennsyl- 
vania; unpublished). 

Glasgow Royal Infirmary, Experimental 
Nursing Training at Glasgow Royal Infirma- 
ry. Edinburgh, Her Majesty's Stationary 
Office, 1963. 

Gorham, William A. Staff nursing behaviors 
contributing to patient care and im- 
provement. Nursing Res., 11:2:68-79, 
Spring 1962. 

Gotkin, Lassar G. An evaluation of the nurs- 
ing performance of the graduates of ex- 
perimental nursing programs in junior and 
community colleges. New York, 1956. 
(Thesis (Ed.D.) - Teachers College, Col- 
umbia University; unpubUshed). 

Lord, A.R. Report of the Evaluation of the 
Metropolitan School of Nursing, Windsor, 
Ontario. Ottawa, The Canadian Nurses' 
Association, 1952. 

Montag, Mildred. Community College Edu- 
cation for Nursing. New York, Blakiston Di- 
vision, McGraw-HUI Book Co., 1959. 

Mussallem, Helen K. Spotlight on Nursing Edu- 
cation. Ottawa, The Canadian Nurses' As- 
sociation, 1960. 

Schmitt^ Louise M. Basic Nursing Education 
Study. Regina, Board of Administration of 
the Centralized Teaching Program for Nurs- 
ing Students in Saskatchewan, 1957. 

Spaney, Emma, Matheney, R.V., Ehrhart, A., 
and Jennings, L. Employer expectations vs. 
staff nurse performance, 1962, (mimeo- 
graphed). Lj 



FEBRUARY 1969 



Marital Breakdown by Jack Dominian. 
172 pages. Harmondsworth, England, 
Penguin Books, 1968. Canadian agent: 
Longmans Canada Ltd. 
Reviewed by Valerie Foumier, Public 
Relations Officer, Canadian Nurses' 
Association, Ottawa. 

The incidence of separation and di- 
vorce continues to rise in the western 
world. Society is only beginning to realize 
that the whole area of marital breakdown 
is a complex and serious problem that 
needs more study and better solutions, 
especially since this society is based upon 
marriage as an institution. 

Jack Dominian, a British psychiatrist, 
explores this area of marriage breakdown 
and urges society to give more attention 
to the problem, particularly through re- 
search. He presents a selected survey of 
both sociological and psychological re- 
search into marriage conducted in the 
United States and Britain, and includes 
his own observations. 

Dr. Dominian stresses that the per- 
sonality and the specific interaction of 
the couple is the most important factor in 
a marriage, and that "every major study 
associates marital disharmony and un- 
happiness with a high incidence of per- 
sonality and neurotic difficulties in the 
partners." 

He picks out three traits typical of 
psychological immaturity that contribute 
most frequently to marriage breakdown: 
failure to achieve the minimum of 
emotional independence; deprivation and 
insecurity; and failure to achieve enough 
self-esteem. He goes on to discuss sexual 
difficulties, birth control, and psycho- 
logical illness. 

Dr. Dominian believes that society has 
three main responsibilities in the field of 
marriage. First, it must try to prevent 
marriages that have little or no chance of 
success. He mentions particularly the 
factors of age, premarital pregnancy, and 
the engagement period, and believes 
"ultimately prevention must be directed 
towards an adequate preparation for 
marriage." 

Secondly, society should help in re- 
conciliation, and he believes marriage 
therapy involves total help with social, 
material, and health problems. Finally, 
society should provide an effective 
system for the dissolution of marriage, 
and here he discusses the role of religion 
and the law in regard to marital break- 
down. 

One drawback for Canadian readers is 
FEBRUARY 1969 



that Dr. Dominian deals with British 
divorce laws, regulations, and machinery 
for counseling, which are in most cases 
inapplicable to this country. 

However, this is not a serious problem, 
and his sensible, realistic and readable 
approach to marital breakdown - which 
applies just as much to Canada as to 
Britain - should more than make up for 
it. 

Erratum 

The book How to Pass Entrance Exami- 
nations for Registered and Graduate 
Nursing Schools reviewed on page 51 in 
the January 1969 issue was erroneously 
stated as being pubHshed by the W.B. 
Saunders Company, Toronto. The book 
was published by Cowles Education 
Corporation, Look Building, 488 Madison 
Ave., New York, N.Y. 

The Unconscious Mind — The Meaning 
of Freudian Psychology by Benjamin 
B. Wolman, 244 pages. Scarborough, 
Ont., Prentice-Hall, Inc., 1968. 
Reviewed by Bernard Lubin, Ph.D., 
Professor, Department of Psychiatry, 
University of Missouri School of Medi- 
cine, Kansas City. 

Fifteen years ago, publishers knew 
that any book on psychoanalysis written 
by almost any psychoanalyst would be a 
a profitable venture. Intelligent laymen as 
well as mental health professionals could 
be relied upon to react almost by reflex 
to the magic of the term "psycho- 
analysis." A major change has occurred 
since then. From its status as "the" major 
theory of personality development and 
method of personality change, psycho- 
analysis was described recently as "the 
best method available for training psycho- 
analysts." The statement says a great deal 
about the irrelevance of psychoanalysis to 
many of today's problems. Conceptual 
models and treatment methods once 
thought to be "superficial" have been 
shown to have much more predictive 
power, to be much less expensive and 
time-consuming, and to be appropriate 
for a much larger proportion of the popu- 
lation. 

Readable accounts of psychoanalysis, 
however, are still quite important, 
whether as essays on recent professional 
history, or, occasionally, as a source of 
testable hypotheses. This is an unusually 
readable and cogent account of the art. 
As in many of his writings. Dr. Wolman 



communicates in this work a sense of 
total grasp of the subject matter and an 
unusual ability to deal with highly com- 
plex material. He writes in an appealing 
manner v^thout sacrifice to the material 
itself. 



The Process of Patient Teaching in Nurs- 
ing by Barbara KJug Redman, K.N., 
B.S.N., M.Ed., Ph.D. 140 pages. Saint 
Louis, Mosby, 1968. 
Reviewed by Sister Mary Irene, Direc- 
tor, School of Nursing, Charlottetown 
Hospital, P.E.I. 



This is a new book designed to provide 
the student with background knowledge 
in the vital area of patient learning. In the 
preface, the author offers this book for 
the student of nursing who recognizes the 
need for patient teaching and for the 
advanced students and graduate nurses 
who have not had formal instruction in 
this area. Essential for competence in 
patient teaching is interaction with the 
patients being taught and sufficient 
knowledge of the subject matter. 

The text begins with an explanation of 
the relevance of teaching to nursing. It 
goes on to present its information in six 
chapters that focus on the process of 
teaching-learning. The first chapter, "The 
Place of Teaching in Nursing" gives a 
historical background of the topic, high- 
lights the objectives of health teaching, 
and assesses what is currently being done. 
It closes with some realistic recommen- 
dations for success in reaching the goal of 
better patient education. 

Other chapter topics are; overview of 
the teacher-learning process; readiness for 
health education; objectives of health 
teaching in nursing; learning and teaching, 
and evaluation of health teaching. 

Many plans of instructional methods 
and techniques are included. The book is 
well documented and includes an ex- 
tensive bibliography that is helpful for 
further study. A few illustrative case 
studies are also included to help the stu- 
dent gain an insight into the practical 
application of what she has learned. 
Study questions are useful as review ma- 
terial. The author emphasizes the need of 
good patient and family teaching as a 
basic factor in the healing process. 
Tlirough her realistic approach to a pract- 
ical problem and often a neglected res- 
ponsibility, she has produced a book that 
should be in every nursing library. 

THE CANADIAN NURSE 65 




History of Nursing , 12th ed., by Jose- 
phine A. Dolan, M.S., R.N. 380 pages. 
Toronto, W.B. Saunders, 1968. 
Reviewed by Sister Madeleine, Direc- 
tor, School of Nursing, St. Joseph 's 
General Hospital, Vegreville, Alto. 

Teachers and students of history of 
nursing will welcome this book, which 
describes the evolution of the role of 
nursing in the history of mankind. 

The text shows the course of nursing 
from primitive cultures to the present. 
Historical facts are enhanced with many 
interesting illustrations and diagrams. 
Throughout the book, emphasis is placed 
on the effect of the cultural, social, 
economic, technical, and spiritual forces 
affecting good nursing. 

The last three chapters on nursing in 
the twentieth century contain up-to-date 
information on such topics as profession- 
al organizations for nurses, nursing edu- 
cation, evaluation of nursing, nursing in 
occupational health, maternal and child 
nursing, hospital social service, psychia- 
tric nursing, and international relations. 
The author shows how the changing pat- 
terns of care of the sick and the refine- 
ment of nursing have been the result of 
the influence of wars, marked progress in 
transportation and communication, and 
remarkable inventions along with many 
scientific achievements. Such timely 
topics as medicare, aerospace nursing. 
Project Hope, and the Peace Corps are 
briefly discussed. 

One other valuable asset of this book 
is the inclusion of a history of nursing in 
Canada. 

This book would be most valuable in a 
course correlating history of nursing with 
professional adjustments. 

Celiac Disease Recipes For Parents And 
Patients 2d. ed. 87 pages. Published by 
The Hospital for Sick Children, Toron- 
to, 1968. 

Reviewed by Shirley Pitt, Nursing 
Coordinator, Home Care Department, 
The Children's Hospital of Winnipeg, 
Manitoba. 

This soft-cover recipe booklet contains 
an introduction by Dr. J. Hamilton. His 
informative summary of the ins and outs 
of celiac disease could be easily read and 
comprehended by the average parent. An 
earlier publication. Celiac Disease: A 
Manual For Parents And Patients, pre- 
pared by the staff at The Hospital for 
Sick Children, Toronto gives a more 
conplete description of the disease and 
the principles of treatment. Dr. Hamilton 
suggests that parents contact their doctor 
66 THE CANADIAN NURSE 



to answer questions that are unanswered 
in these booklets. 

The booklet's most commendable 
feature is that it integrates the child and 
the medical problem with the family set- 
up. Families who are attempting to cope 
with an ill child would benefit from more 
literature written along these same lines. 

The list of allowed and not allowed 
foods is helpful, as is the sample meal 
plan. This page would be more useful if 
printed on separate tear-out cards, one 
for the food hst, and one for the sample 
meal plan. The cards could be placed in a 
convenient place in the kitchen to be 
used for quick reference by parents. 

The section headed "General Sug- 
gestions" presents a variety of helpful 
hints for mother to follow in the pre- 
paration of her child's diet. The in- 
formation that glutin-free bread mix is 
available by mail from a Toronto firm is 
useful. However, no additional infor- 
mation is supplied regarding the availa- 
bility of this item in other Canadian 
centers or its approximate cost, infor- 
mation of importance to parents in pro- 
viding the glutin-free diet to their child. 

The recipes are indexed for quick 
reference; throughout the recipes are 
helpful hints for easy preparation and 
storage. 

This booklet is a useful aid for parents 
caring for a child with celiac disease. 
Pediatricians, pediatric nurses, and public 
health nurses should be knowledgeable 
of this book. 

A Manual for Team Nursing developed by 
Mercy Hospital, Pittsburgh, Pennsylva- 
nia. 56 pages. St. Louis, The Catholic 
Hospital Association, 1968. 
Reviewed by Sister Mary of Calvary, 
Director, Nursing Education, St. Mi- 
chael's School of Nursing, Lethbridge, 
Alberta. 

This manual on team nursing is me- 
thodically presented in four sections. 
Section 1 includes the history of team 
nursing, its philosophy, and some elabo- 
ration on "Why Team Nursing." The 
concept of team nursing is aptly describ- 
ed by the authors as a "plan which en- 
courages the development of leadership, 
cooperation and conversation among all 
members of the health team and recog- 
nizes the individual worth more fully." It 
involves planning, working, learning, and 
conferring together, resulting in improved 
patient care. 

The diagrams used portray vividly 
both the organizational set-up of tra- 
ditional nursing with its task-oriented 
care and patient-centered team nursing. 
Section 2 deals with the imple- 
mentation of the team nursing pattern. 
This involves breaking down "resistance 
to change," a characteristic that in- 
variably accompanies any effort to de- 
viate from the traditional. The personnel 



comprising the team are outlined and the 
role and responsibility of each member is 
clearly dehneated. Samples of team as- 
signment forms are included. The team 
report and the team conference are part 
and parcel of the team concept. These 
serve to keep all members of the team 
properly informed of the objectives they 
are trying to achieve besides bringing 
about concerted effort on the part of all 
for more realistic patient-centered care. 

The nursing care plan that results from 
the team conference is described as a 
brief word picture of the patient that por- 
trays him as an individual. The plan serves 
as a guide for all the members of the team 
in carrying out patient care and helps in 
the effective utilization of nursing care 
hours. 

A well selected hst of 21 nursing 
problems is outlined in the manual for 
the guidance of persons caring for pa- 
fients. These, hopefully, will be useful in 
helping to determine the individual needs 
and problems of the padents but should 
in no way take the place of observation 
and experience. 

Section 3 presents with clarity 13 
steps toward a successful team nursing 
program. 

The last section contains an excellent 
and extensive bibliography. 

In the material presented in this nurs- 
ing team manual there is evidence of 
much thoughtful planning and forward 
thinking. A study of this manual would 
be invaluable to anyone who is contem- 
plating replacing the traditional pattern 
of patient care with the nursing team 
concept. 

Infection Control in the Hospital . 140 

pages. Chicago, American Hospital As- 
sociation, 1968. 

Reviewed by Dorothy Pequegnat, In- 
fection Control Officer, Ottawa Civic 
Hospital, Ottawa. 

This book is a collection and evalu- 
ation of current useful information on 
the control of nosocomial infections. The 
authors recognize that each hospital 
varies from the others, and that the appli- 
cation of their recommendations there- 
fore will vary, but that the principles pre- 
sented apply generally to all hospitals. 

If hospital facilities, practices, or pro- 
cedures are at fault, the hospital can be 
sued for corporate negligence. Therefore, 
a hospital should at least adopt the mini- 
mal standards as recommended in this 
book by the American Hospital Associ- 
ation and the Joint Commission on Ac- 
creditation of Hospitals. 

The book can be divided into three 
parts. The first section deals with the gen- 
eral organisation of hospital responsibili- 
ties. It provides guidelines for the 
establishment of an infection control 
committee, employee health service, edu- 
cation programs, and surveillance activi- 

FEBRUARY 1%9 




ties for the infection control nurse. 
Sample forms are also given for reporting 
of infections. 

The second part of the book consists 
of specific responsibilities within the 
hospital: the individual responsibility of 
the administrator, physician, and nurses, 
and the departmental responsibilities of 
the microbiological laboratory, pharma- 
cy, central supply service, food service 
department, laundry and hnen service, as 
well as engineering and maintenance de- 
partment. 

The third part of the book deals with 
prevention and control of infection. The 
information includes architectural con- 
siderations with a sample isolation plan, 
microbial sampling programs, and, most 
important, isolation techniques and pro- 
cedures. Special problems are also con- 
sidered: those of infected personnel and 
carriers, hazardous areas such as the 
blood bank, the surgical suite, and the 
newborn nursery, and hazardous pro- 
cedures such as inhalation therapy, trach- 
eostomy, wound dressing, and catheteriz- 
ation. 

This book is most timely; not only 
' does it present the problem of infections 
;in hospitals but provides helpful guide- 



lines and recommendations to help es- 
tablish a workable infection control pro- 
gram. It is a must for quick reference for 
all department heads concerned with the 
prevention and control of infections. 

The Care & Feeding of Your Diabetic 
Child by Sally Vanderpoel. 1 1 6 pages. 
Toronto, Geroge J. McLeod, Ltd., 
1968. 

Reviewed by Joy Calkin, Lecturer, 
School of Nursing, The University of 
New Brunswick, Fredericton, N.B. 

The author, a nutritionist and mother 
of a diabetic child for 10 years, has 
written this book for parents. It would be 
a valuable addition to a pediatric unit 
parents' library, a pediatrician's office, 
local community library, or nursing agen- 
cy. However, its value is not limited to 
parents. Its practicality and its orien- 
tation toward helping the child and 
parents adapt to diabetes make the book 
valuable for anyone working with the 
child with diabetes. 

Two concerns must be balanced by the 
parents of the diabetic child. How does 
the parent help the child to gain inde- 
pendence and self reliance, while at the 
same time observing and controUing 
"every phase of his life"? From her ex- 
perience, the author describes certain pro- 
cedures that are part of diabetic care. For 
example, she gives her son his injections 
when he is at home, and he gives them in 



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her absence to "keep in practice." Her 
rationale is that by giving the injections in 
sites inaccessible for self-administration 
(such as the buttocks) she helps her son 
maintain the sites that he must use when 
he provides his own care in the years 
ahead. 

Information and suggestions related to 
food exchange (included in the ap- 
pendix), school lunches, travel, special 
occasions as birthdays, compHcations, in- 
volvement in sports and other activities, 
and the adolescent with diabetes are clear 
and reasonable. The author notes some of 
the problems she and her husband have 
encountered and what kinds of solutions 
they have used, and encourages parents to 
see what works best in their situation and 
family. 

The brief history of diabetes mellitus 
and its treatment will help prevent some 
of the misunderstandings that occur 
about diabetes. Note is made of the di- 
rection of current research. The roles of 
the specialist and general practitioner are 
discussed in relation to their helpfulness 
to the child and parents. 

The tone of the book is realistic, yet 
optimistic in relation to the "controlled" 
diabetic, and Mrs. Vanderpoel notes that 
there are advantages to the child and 
family in spite of the chronic disorder. 
She makes a plea for honesty, truth, and 
knowledge for the child - so necessary 
for adaptation to any chronic illness. Her 
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FEBRUARY 1969 



THE CANADIAN NURSE 67 




ities grow by encountering a difficulty 
and mastering it . . . There is no need to 
compensate him for the things that he 
does not have or must do without. Given 
the opportunity to do so, he will com- 
pensate in his own wholesome way." 

This book would be useful for parents 
and health workers who seek this as their 
goal of care. 

Total Patient Care, Foundations and Prac- 
tice, 2nd ed.. by Dorothy F. Johnston, 
R.N.. B.S., M.Ed. 526 pages. St. Louis, 
Mosby, 1968. 

Reviewed by Iva J. Yeo, Instructor, St. 
Boniface School for Practical Nurses, 
Man. 

The theme of this excellent textbook, 
as stated in the preface, is the patient as 
an individual, the constant need for the 
practical nurse to record and report, and 
the understanding on her part that she is 
a member of the nursing team. This 
second edition does not carry new 
chapters but has updated many of the 
original ones. 

One chapter that has been rewritten 
deals with the patient with staphylo- 
coccal infections. In this chapter, the 
practical nurse is given an understanding 
of the sources of infection, clinical mani- 
festations, nursing care, and prevention. 
Isolation technique, including medical 
and surgical asepsis, is not very detailed, 
but a good basis is established. More in- 
formation regarding this is given in an- 
other chapter, which deals with com- 
municable diseases. Because of the va- 
riation in individual hospital poHcy, 
further discussion is probably unneces- 
sary. 

In some areas, it might have been more 
beneficial to focus a little more narrowly. 
For example, much of the information in 
Chapter 1 1 under subtitles "Blood Pro- 
ducts" and "Diagnostic Tests and Pro- 
cedures" could have been omitted or less 
detailed. However, if the author's intent 
was to provide a one-book reference upon 
completion of the practical nurse's formal 
education, she may have felt it necessary 
to include the wider scope of technical 
information. 

Tlie text provides an extensive list of 
current references at the completion of 
each chapter plus a detailed glossary at 
the end of the book. Many well-identified 
illustrations, diagrams, and charts are of 
particular merit. As noted in the first 
edition, this textbook reflects changes in 
concepts, ideas and attitudes, not merely 
part of the evolutionary growth of nurs- 
ing. It is a valuable addition to schools for 
practical nurses and, as stated before, as a 

68 THE CANADIAN NURSE 



reference for the licensed practical nurse 
working in areas such as smaller county 
hospitals, convalescent or nursing homes, 
or in private duty. 

The Interview in Sludent Nurse Selection 
by C.H. Smeltzer, Ph.D. 185 pages. 
New York, G.P. Putnam's Sons, 1968. 
Canadian publisher: The Macmillan 
Company of Canada Ltd., Toronto. 
Reviewd by Dorothy Syposz, 
Lecturer, School of Nursing, Lakehead 
University, Port Arthur, Ont. 

This book is primarily directed to 
faculty members of diploma schools of 
nursing who are involved in interviewing 
applicants. Although the major concern is 
the interview as a tool in the selection of 
students, other elements of selection are 
also discussed to emphasize the necessary 
balance in criteria. 

The topics covered include answers 
and information on almost all aspects of 
the interview such as: the importance of 
the interview in student selection, the 
choice of faculty as interviewers, the de- 
velopment of interview ability, common 
faults of interviewers, methods of inter- 
viewing, and the use of interview evalu- 
ation in selection. 

The author states his belief at the 
beginning of the book that, if the inter- 
viewing phase of selection is properly 
conducted or can be improved, this part 
of the selection process will contribute to 
a reduction of the attrition rates. With 
the purpose of improving the technique 
of interviewing, the whole approach 
stresses the practical aspects rather than 
the theoretical. For instance, one chapter 
discusses methods such as individual, 
team, multiple interviewing, and types of 
interviews with lists of specific questions 
relating to the area to be explored, such 
as personal background, work experience, 
uiterest in nursing, and attitudes. Another 
chapter deals with the vital aspect of re- 
cording and consolidafing interview 
summaries. Brief mention is made of 
various methods of recording, and the re- 
mainder of the chapter describes a 
graphic chart developed by the author 
and explains how this may be used. The 
last chapter outlines briefly 34 problems 
in interviewing candidates for entrance to 
a school of nursing; these merit research 
and study. 

This practical book would be of value 
to any teacher of nursing who is inter- 
viewing prospective students, whether 
they are in a diploma or collegiate pro- 
gram, and to administrators who are con- 
cerned with the interview as a tool in 
student nurse selection. 

Saunders Tests for Self Evaluation of 
Nursing Competence by Dee Ann Gil- 
lies, R.N., M.A., and Irene Barrett 
Alyn, R.N., M.S.N. 282 pages. Toron- 
to, W.B. Saunders, 1968. 



Reviewed by Dr. M. Josephine Flaher- 
ty, Assistant Professor, Department of 
Adult Education. Vie Ontario Insti- 
tute for Studies in Education, Toron- 
to, Ontario. i 

According to the authors, this book of 
tests of nursing competence is designed 
"both to instruct and to evaluate previous 
learning." Since the test items are 
comparable to those that nurses might en- 
counter on licensure or graduate nurse 
achievement examinations, the authors 
intend the book to be of use to basic 
nursing students, graduate nurses, and 
nurse-teachers. They suggest also that 
nurses returning to practice after an 
absence of some years would find the 
book of value as a "narrative redefinition 
of a scene that has changed since their 
last view of it." 

The text is divided into four major 
sections devoted to the following areas: 
maternity and gynecological nursing, 
pediatric nursing, medical-surgical nurs- 
ing, and psychiatric nursing. Within each 
secfion there is further subdivision into 
disease-centered units where nursing situ- 
ations are described and multiple-choice 
test items based on these situations are 
provided. A bibliography of books and 
articles related to the subject areas being 
tested is provided for each of the major 
sections of the book. 

Although the title of this book 
mentions evaluation of nursing com- 
petence, no attempt is made by the 
authors to explain exactly what is meant 
by nursing competence. It is presumed, 
however, that the tests in this book, 
nursing licensure examinations, and 
graduate nurse achievement examinations 
share a similar aim: to assess a candidate's 
ability to use nursing knowledge in 
making decisions that result in safe nurs- 
ing practice. Judgments about whether 
tests are appropriate for use in particular 
situations are based on assessments of the 
characteristics - such as validity, dif- 
ficulty and so forth - of the tests. The 
validity of any set of test items can be 
determined only in terms of a well- 
defined set of objecfives describing the 
behaviors being measured, and with refer- 
ence to a population that has been 
identified. The authors mention that 
items in each section vary considerably in 
difficulty so that the abilities of both 
undergraduate nursing students and 
graduate nurses can be tested; however, 
no attempt is made to define the specific 
nursing behaviors that are expected of the 
different groups of examinees. Hence, 
users of this book may find it difficult to 
identify appropriate test items and make 
meaningful evaluations of nursing compe- 
tence based on the given tests. 

The usefulness of this book for nursing 

students or graduate nurses who wish to 

refresh their nursing knowledge is 

quesfionable. Although correct answers 

FEBRUARY 1969 




are given for all items, the answers are 
without explanation and some could 
probably be debated. There is danger that 
persons using this book might accept 
given answers without understanding 
them fully. Had the authors provided for 
students a clear explanation of the use of 
the test items as a means of identifying 
weaknesses and gaps in knowledge, and 
made specific suggestions for remedial 
work, the book might have been more 
useful. 

Similarly, graduate nurses wishing to 
refresh their nursing skills would likely 
have difficulty understanding the nature 
of changes in nursing without consider- 
ably more detail than that provided in 
this book. Hopefully, both students and 
graduates would make use of the bibli- 
ographies provided, but more direction 
would probably be required. 

While nurse-teachers might find the 
book of some value as a source of ideas 
for teaching and testing, they would have 
to make careful assessments of the suita- 
bility of the situations and items for their 
particular settings; hence teachers' use of 
the book is likely to be somewhat restric- 
ted. 



On the whole, this book seems to have 
limited value as an instrument for self- 
evaluation of nursing competence and is 
not recommended for libraries in schools 
of nursing. 

A Unified Health Service by David Owen, 
Bemie Spain, and Nigel Weaver. Edited 
by Dr. David Owen, M.P. 148 pages. 
Toronto, Pergamon of Canada Ltd., 
1968. 

Reviewed by Sheila Rymer, Health 
Educator, Department of National 
Health and Welfare, Ottawa. 



This book was coauthored by David 
Owen, a doctor who is a member of the 
British Parliament; Nigel Weaver, a 
hospital administrator; and Bemie Spain, 
a research worker in social and communi- 
ty studies in London, England. 

The chapter headings indicate that the 
authors intend to describe the evolution 
of Britain's National Health Service, its 
present structure, the place of the general 
practitioner, and the failure of the tri- 
partite administration to provide a work- 
able, coordinated health service. Pro- 
posals are made for organization of a 
unified health service, management and 
administration of Area Health Boards, the 
general practitioner and community ser- 
vices, mental health services, and welfare 



services. The appendix includes tables of 
statistics and case histories. 

Unfortunately for the reader unfami- 
liar with British terminology, the authors 
lapse into an alphabetical soup. If the 
National Health Service is as confusing as 
the book, it is a wonder patients get any 
care at all. 

Apparently the Service is organized 
under three different administrations: 1. 
hospitals and specialist services; 2. local 
Health Authority services responsible for 
prevention of illness, home nursing, mid- 
wifery etc., and 3. Executive Council 
Services, responsible for general practi- 
tioners, dental practitioners, ophthaniolo- 
gists, opticians, and chemists. Each of 
these services has administrative units at 
the local level and evidently no two have 
the same boundary lines. This means that 
a doctor discharging a patient from hospi- 
tal and wishing to have him followed at 
home has to know which office of the 
Health Authority Service to call for each 
of the districts in which he practices. It 
means that there is no administrative 
means for the sp)ecialist who has given the 
patient hospital care to communicate 
with the general practitioner, much less a 
home visitor nurse who might be looking 
after the patient at home. It means that 
there is no means (in fact there are obsta- 
cles) for interservice planning of programs 
or facilities. 

This book should prove useful for 



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THE CANADIAN NURSE 69 




those involved in planning community 
health services in that it gives consider- 
able emphasis to the need for communi- 
cation among the growing numbers of 
health specialists and organizations. 



Infectious Diseases, 5th ed.. by A.B. 
Christie, M.A., M.D., D.P.H., D.C.H. 
371 pages. London, Faber and Faber, 
1968. 

Reviewed bv Dr. D.W. Menzies, M.B., 
Ch.B.. Ph.D., M.C.P.A. Medical Officer 
in Charge, Field Study Unit, Epidemi- 
ology Division, Department of Na- 
tional Health and Welfare, Ottawa. 

Since the time that this well-known 
and useful text for nurses was first pub- 
lished revolutionary changes have occur- 
red in the treatment of infectious disease. 
Tuberculous meningitis is no longer fatal, 
poliomyelitis has been reduced to an item 
on a printed page, and clinical diphtheria 
is becoming more and more a rarity. 

Condensing all this new knowledge 
into a simple and readable style, combin- 
ed with accuracy, is no mean feat. On the 
whole the book does this well. The 
section on hospital sepsis is a good ex- 
ample of the author at his best. 

Some sections do, however, require 
further revision. The discussion on in- 
fectious hepatitis specifies an incubation 
period 25 to 35 days - which would 
cause some eyebrows to rise. Usually, two 
to six weeks is quoted. The incubation 
period of serum hepatitis is somewhat 
vaguely described as about 100 days. 
Eiglit to 22 weeks is more in accord with 
current thinking. A recommendation is 
made to isolate the jaundiced patient at 
home, in spite of the known probability 
that other family members would already 
be affected. The section on tetanus pro- 
phylaxis requires some updating; its re- 
commendations relating to antitoxin are 
unfortunately imprecise. Illustrations no. 
8, 9, 10, and 11 should be reconsidered. 
They are not up to the general standard 
of the book. It is also worth noting, in 
the section about venereal disease, that 
the "promiscuous" person is not neces- 
sary unstable and immature, as the author 
implies. Not only the psychologically 
sick, but the apparently normal individual 
contributes to the venereal disease pro- 
blem. 

In spite of these minor blemishes, the 
book does what it sets out to do and its 
continuing popularity is a measure of its 
value. Nurses, health visitors, public 
health inspectors, and student teachers 
will find it very useful for reference 
purposes. 

70 THE CANADIAN NURSE 



Health Services Administration: Policy 
Cases and the Case Method edited by 
Roy Penchansky D.B.A. Cambridge. 
Harvard University Press, 1968. 
Reviewed by Frances Howard, Con- 
sultant Nursing Sen'ice, Canadian 
Nurses ' A ssociation, Ottawa. 

The editor's words in the preface of 
tliis volume document the value of this 
text as a reference text for both edu- 
cators and practicing administrators, 
whatever their area of management might 
be: "It is . . . my belief that to develop 
skills in the administrative processes it is 
necessary to employ a teaching technique 
that provides the student with guided ex- 
perience in such processes and, further, 
that the case method of teaching ... is 
one of the most useful of such teaching 
techniques." 

The volume contains 12 case studies 
describing real-life events that have oc- 
curred not only in the western hemis- 
phere but also in other parts of the world. 
These case studies have an added ad- 
vantage in that they provide historical re- 
ferences not easily obtained from other 
sources. In addition, there are specific 
papers illustrating the use of the case 
method in the education of health service 
administration personnel. D 



accession list 



Publications on this list have been re- 
ceived recently in the CNA library and are 
listed in language of source. 

Material on this list, except Reference 
items, which include theses and archive 
books that do not circulate, may be bor- 
rowed by CNA members, schools of nurs- 
ing and other institutions. 

Requests for loans should be made on 
the "Request Form for Accession List" and 
should be addressed to: The Library, Cana- 
dian Nurses' Association. 50 The Drive- 
way, Ottawa 4, Ontario. 

No more than iliree titles should be re- 
quested at any one time. If additional titles 
are desired, these may be requested when 
you return your loan. 

BOOKS AND DOCUMENTS 

1. ALA rules for fitins catalog cards by 
Pauline A. Seeley. 2d. ed. Chicago. Amer- 
ican Library Association, 1968. 260p. 

2. World Iteallh or.vaiiizcitioii album. 
Geneva, World Health Organization, 1968. 
9lp. 

3. And after that nurse? by Roger Brook. 
London, Souvenir Press, 1966. 61 p. 

4. Canadian society: .sociological perspec- 
tives edited by Bernard Blishen, Frank E. 
Jones, Kaspar D. Naegele, John Porter. 3d 
ed. Toronto, Marmillan, 1968. 877p. 



5. Cleaning and preserving bindings and 
related materials by Carolyn Horton. Chica- 
go. American Library Association, 1967. 76p. 

6. The continuing education of women; 
some programs in the United States of 
America by Marion Royce. Toronto, De- 
partment of Adult Education. Ontario Insti- 
tute for Studies in Education, 1968. 155p. 

7. Contraception divorce abortion; three 
statements by Canadian Catholic Confer- 
ence; discussion outline by CCC, Family 
Life Bureau, Ottawa, 1968. 64p. 

8. Diet manual prepared by Ontario Diet- 
etic Association and approved by The On- 
tario Medical Association. 2d ed. Toronto, 
Ontario Hospital Association, 1967. Iv. 

9. Final report of the New York (State) 
University. Associate Degree Nursing Pro- 
ject 1959-1964 to the W.K. Kellogg Foun- 
dation. New York, N.Y., 1964. 102p. 

10. Guidelines for discharge planning by 
Janis H. David, Johanne E. Hanser and 
Barbara W. Madden. California, attending 
Staff Association of Rancho Los Amigos 
Hospital. 1968. 52p. 

1 1 . Health visiting practice by Mary 
Saunders. Oxford, Pergamon. 1968. Il2p. 

12. Infection control in the hospital. Chi- 
cago. American Hospital Association. 1968. 
I40p. 

13. The lung and its disorders in the new 
horn infant by Mary Ellen Avery. 2d ed. 
Toronto, Saunders, 1968. 285p. 

14. Manual of the international statistical 
classification of diseases, injuries, and causes 
of death. Vol. 1. 1965 rev. Geneva, World 
Health Organization. 1967. 478p. 

15. Note on the proceedings of the sixth 
session International Labour Organisation 
Advisory Committee on Salaried Employees 
and Professional Workers. Geneva 4-14 De- 
cember, 1967. Geneva, 1967. 88p. 

16. Nurse! A guide for the establishment 
of refresher courses for registered nurses. 
New York, American Nurses' Association, 
1968. 49p. 

1 7. Occupational education; a challenge to 
the two-year college edited by Bonnie E. 
Cone and Philip D. Varo. North Carolina, 
University of North Carolina, 1967. 55p. 

18. The operating room supervisor at 
work in New York by Edna A. Prickett. 
National League for Nursing, cosponsored 
by American Hospital Association, 1955. 
112p. 

19. Papers from the Canadian Confer- 
ence on Educational Measurement, Sixth, 
Laval University, Quebec, June, 1968. Otta- 
wa, Canadian Council for Research in Edu- 
cation. 1968. Contents. — Individualizing 
educational measurement by J. Walla, P. 
Somwaru. — Academic freedom in the 
classroom by Thomas W. Whiteley. — 
Teacher militancy by S.C.T. Clarke. — Two 
necessary conditions for creativity by H.I. 
Day and R. Langevin. 

20. Patients; nurses; and chronic respira- 
tory diseases. New York, National League 
for Nursing. 1968. 46p. 

21. The person as a nurse; professional 

FEBRUARY 1969 



accession list 



adjiisimenis by Florence C. Kempf. New 
York. Macmillan. 1951. 226p. 

22. Pharmacie, par Yvan Toiiitou. Paris, 
Masson, 1968. 223p. 

23. The pharmacologic basis of patient 
care by Mary Kaye Asperheim. Philadelphia. 
Saunders. 1968. 417p. 

24. Plan liospiialier d'lirgence. Montreal. 
Hopital Notre-Danie. 1966. Iv. 

25. The prediction of success in nursing 
education: phase I and 2, 1959-67; a manual 
for Luther Hospital sentence completions 
and the luirsing sentence completions by 
John R. Thurstin, Helen L. Brunclik and 
John F. Feldhusen. Eau Claire, Wisconsin. 
1967. 196p. 

26. The prediction of success in nursing 
education, phase 3. 1967-68 by John R. 
Thurstin, Helen L. Brunclik and John F. 
Feldhusen. Eau Claire, Wis.. 1968. 114p. 

27. Proceedings of the Conference on 
Training in Family Medicine, University of 
Western Ontario, London, May 13 - 15, 
1968 sponsored jointly by the Association of 
Canadian Medical Colleges and the College 
of Family Physicians of Canada. Toronto, 



College of Family Physicians, 1968. iiip. 

28. Reference: a programmed instruction 
by Donald J. Sager. Ohio, Ohio Library 
Foundation. 1968. 147p. 

29. Report of the Commission on the 
Canadian Public Health Association. To- 
ronto, 1968. 62p. 

30. Report of research project no. 1 by 
M. L. Gingras. Toronto, Canadian Council 
on Hospital Accreditation, 1968. 141p. 

31. Report of a 1966-68 project to assess 
Illinois' nursing resources and needs, present 
and projected to 1980, and develop a pro- 
gram of action to meet the state's needs for 
nursing services sponsored by the Illinois 
League for Nursing and the Illinois Nurses' 
Association. Chicago, Illinois League for 
Nursing, 1968. 64p. 

32. Report of the Hospital Research and 
Educational Trust 1968. Chicago. 1968. 25p. 

33. Report of informal discussion of con- 
tinuing education for women, May 9, 1968. 
Toronto, Ontario Institute for Studies in 
Education, Adult Education Department, 
1968. Iv. 

34. Report of a Seminar on Nursing Edu- 
cation, Georgetown, Guyana, 17-30 April, 
1968. Washington, Pan American Sanitary 
Bureau, 1968. 75p. 

35. Reports of the committees on nursing 
service administration of the Nursing Ser- 



vice Administration Seminar, University of 
Chicago, Jan. 15 - June 8, 1951. Chicago, 
University of Chicago, 1952. 21 Ip. 

36. Sickness and society by Raymond S. 
Duff and August B. Hollingshead. New 
York. Harper & Row. 1968. 390p. 

37. Student nur.ses in Scotland: character- 
istics of success and failure by Margaret 
Scott Wright and Audrey L. John. Edin- 
burgh. Scottish Home and Health Depart- 
ment. 1968. 153p. 

38. Vietnam doctor: the story of project 
concern by James W. Turpin with Al Hirsh- 
berg. Toronto, McGraw-Hill, 1966. 21 Op. 



PAMPHLETS 

39. Community planning for nursing edu- 
cation; the experiences of two state nurses' 
associatioiu in planning for nursing educa- 
tion in their areas by Lucille C. Notter and 
Kathryn M. Smith. New York. American 
Nurses' Association, 1968. 26p. 

40. Evaluation of luir.ung staff. Milk 
River, Alberta, Alberta Association of Reg- 
istered Nurses, South District, Supervisory 
Nurses' Committee, 1968. 7p. 

41. Guidelines for cancer content in re- 
fresher courses for registered nurses. New 
York. American Cancer Association. 1968. 
12p. 

42. Guidelines for cardiovascular disease 



Request Form 
for "Accession List" 

CANADIAN NURSES' 
ASSOCIATION LIBRARY 

Send this coupon or facsimife to: 
LIBRARIAN, Canadian Nurses' Association, 
50 The Driveway, Ottawa 4, Ontario. 

Please lend me the following publications, listed in the 
issue of The Canadian Nurse, 
or add my name to the waiting list to receive them when 
available. 



Item 
No. 



Author Short title (for identification) 



Request for loans will be filled in order of receipt. 
Reference and restricted material must be used in the 

CNA library. 

Borrower 

Registration No. 

Position 

Address 

Date of request 




FEBRUARY 1969 



THE CANADIAN NURSE 71 



accession list 



content in refresher courses for registered 
nurses by Haltie Mildred Mclntyre. New 
York, American Heart Association, Commit- 
tee on Nursing Education, 1968. 13p. 

43. Hi filler education for nurses. Tel Aviv, 
Tel-Aviv University, Faculty of Continuing 
Medical Education, Department of Nursing, 
1968. 4p. 

44. The 1968 fact book on Canadian 
consumer magazines. Toronto, Magazine 
Advertising Bureau of Canada, 1968. 23p. 

45. Nurse — facuhy census 1968. New 
York, National League for Nursing, Re- 
search and Development Staff, 1968. lip. 

46. The occupational health nursing 
course by Ida Sharpies. Vancouver, 1961. 
34p. 

47. Remarks on the adjunct to the pre- 
amble of the "Code of Ethics" by Anny 
Pfirter. Geneva, Comite International de la 
Croix-Rouge, 1967. 21 p. 

48. Salary pronouncement. New York, 
American Nurses' Association, 1968. 4p. 

49. Schools of nursing/ RN, 1968. New 
York, American Nurses' Association, 1968. 
pam. 

50. Summary of library orientation pro- 
grammes in eight Canadian university libra- 
ries by Canadian Association of University 
and College Libraries, rev. ed. Ottawa, Can- 
adian Library Association, 1968. 15p. 

51. Teaching medical-surgical nursing; 
papers presented at the 1962 regional meet- 
ings of the council of member agencies of 
the Department of Diploma and Associate 
Degree Programs, and ... by, Mildred L. 
Brown, Charlotte Gray and Marie A. 
Warnche. New York, National League for 
Nursing, Department of Diploma and Asso- 
ciate Degree Programs, 1963. 43p. 

GOVERNMENT DOCUMENTS 

Canada 

52. Bureau federal de la Statistique. Clas- 
sification Internationale des maladies, adap- 
tee. Ottawa, 1968. 2v. 

53. Bureau of Statistics. Advance stalls 
tics of education 1968/69. Ottawa, Queen's 
Printer, 1968. lip. 

54. . Canada yearbook; official 

.statistical annual of the resources, history 
institutions and social and economic condi- 
tions of Canada. Canada Year Book, Hand- 
book and Library Division. Ottawa, Queen's 
Printer. 1277p. 

55. . Causes of death, Canada; 

provinces by sex and Canada by sex and 
age, 1966. Ottawa, Queen's Printer, 1968. 
97p. 

56. . Canadian statistical review; 

annual supplement, 1967. Ottawa, Queen's 
Printer, 1968. Iv. 

57. . Statistics of private trade 

.schools, 1965-66. Ottawa, Queen's Printer. 

72 THE CANADIAN NURSE 



1968. 4p. 

58. . Vital statistics, 1966. Ottawa, 

Queen's Printer, 1968. 213p. 

59. Dept. des Impressions et de la Pape- 
terie publiques, L'administrateur federal du 
Canada, 1965-1968. Ottawa, Imprimeur de 
la reine, 1965. Iv. 

60. Dept. of Labour. Economics and Re- 
search Branch. The behaviour of Canadian 
wages and salaries in the post war period. 
Ottawa, Queen's Printer, 1967. 120p. 

61. Dept. of Manpower and Immigration. 
Career outlook community colleges grad- 
uates, 1968-1969. Ottawa, Queen's Printer, 
1968. 58p. 

62. . How to run a business, rev. 

ed. issued jointly by . . . and Department of 
Industry. Ottawa, Queen's Printer, 1968. 
203p. 

63. Dept. of National Health and Wel- 
fare. Digest of symposium on control of 
hazards in hospitals, September 19, 1967. 
Ottawa, Queen's Printer, 1968. 53p. 

64. Dept. of National Health and Wel- 
fare. New dimensions in aging. Ottawa, 
Queen's Printer, 1968. 7]p. 

65. . Report of the survey of 

health unit services in eight provinces of 
Canada, 1960. Ottawa, 1961. 15 Ip. 
Montreal 

66. Department of Health Report, 1967. 
Montreal, 1967. 21 Op. 
Ontario 

67. Dept. of Health. Research and Plan- 
ning Branch. A study of withdrawals of stu- 
dent nurses from schools of nursing in On- 
tario; students enrolling in 1956-1961. Pre- 
pared by . . . and the Vital and Health Sta- 
tistics Unit in collaboration with the Col- 
lege of Nurses of Ontario, Toronto, 1968. 
62p. 

Trinidad and Tobago 

68. Ministry of Health. Report on a quan- 
titative and qualitative survey of nursing 
needs and resources. Trinidad Government 
Printery, 1968. 55p. 
U.S.A. 

69. Bureau of Employment Security. 
Manual for uses clerical skills tests. Wash- 
ington, Government Print Off., 1968. 55p. 

70. Department of Health, Education and 
Welfare. Public Health Services. Utilization 
review; a selected bibliography 1933-1967. 
Arlington, Va., 1968. 19p. 

71. National Center for Radiological 
Health. An acclimation room for the detec- 
tion of low radium 226 body burdens by 
Samuel D. Campbell and Denis E. Body. 
Washington, U.S. Public Health Service, 
1968. 19p. 

72. National Center for Radiobiological 
Health. Radiation bio-effects. Summary re- 
port, January - December, 1967. Washing- 
ton, U.S. Public Health Service, 1968. 1 19p. 

73. Secretary of Health Education and 
Welfare. Health in America: The role of the 
federal government in bringing high quality 
health care to all American people; a report 
to the President. Washington. 1968. 35p. 



STUDIES DEPOSITED IN 

CNA REPOSITORY COLLECTION 

74. Community planning for a nursing 
program in the Red Deer Junior College; 
report to the Committee on Nursing Educa- 
tion of the Red Deer General Hospital by 
Jean Mackie, Red Deer, Alta., 1965. 64p. R 

75. A comparison of students' achieve- 
ment on a sequential learning experience 
with other measures of student progress by 
M. Claire Rheault. Montreal, 1968. 63p. 
Thesis (M.Sc.(App)) McGill. R 

76. Criteria used by employers when sel- 
ecting nursing staff in varying sized hospi- 
tals by Margaret Feme Trout. Toronto, 
1964. 129p. Thesis (Dip. in Hosp. Admin.) 
Toronto. R 

77. Etude des infirmieres employees a 
mi-temps au Quebec: la .satisfaction person- 
nelle de ce groupe et la satisfaction institu- 
tionnelle by Nicole DuMouchel. Montreal, 
1968. 115p. Thesis (M.N.) Montreal. R 

78. Nurses' .selection or avoidance of pa- 
tients in the terminal phase of prolonged ill- 
ness in selected medical and .surgical tinits 
of a general hospital by Sister Jacqueline 
Bouchard. Washington, 1964, 85p. Thesis 
(M.Sc.N.) Catholic University of America. R 

79. Nursing utilization study, pediatric 
ward by K.J. Fyke. Regina, Saskatchewan, 
Regina Grey Nuns' Hospital, 1966. 25p. R 

80. The relationship between continuity of 
nurse-patients' assignment and the patients' 
knowledge of self-care by Devamma Purus- 
hotham. Montreal, 1968. 41 p. Thesis (M.Sc. 
(App)) McGill. R 

81. The relalioiLship between the physical 
adjustment of children to diabetes and the 
marital integration of their parents by Mar- 
lene A. Lane. Montreal, 1968. 58p. Thesis 
(M.Sc.(App)) McGill. R 

82. Relationships between attitudes to 
nursing, job satisfaction and professional 
organization membership by A. Joyce Bai- 
ley. Cleveland, Ohio, 1968. 74p. Thesis 
(M.Sc.N.) Western Reserve. R 

83. Report to the Committee on Educa- 
tion, University of Alberta on a suggested 
curriculum for Red Deer Junior College in 
affiliation with Red Deer General Hospital. 
Red Deer, Alberta, Red Deer General Hos- 
pital, Committee on Nursing Education. 
Task Committee on Curriculum. 1966. 16p. 
R 

84. A study of the attitudes of nurse fa- 
culty members in a selected Canadian pro- 
vince in relation to their educational func- 
tions by Sister Huberte Richard. Washing- 
ton, 1963. 59p. Thesis (M.Sc.N.) Catholic 
University of America. R 

85. A study of the needs of graduates 
from two year diploma programmes in Can- 
ada, by Ella B. MacLeod and Sister Cather- 
ine Peter. Boston, 1968. 74p. Thesis (M. 
Sc.N.) Boston. R 

86. A study to determine — is the nurse 
in a double-bind when caring for patients on 
isolation care by Alva L. Peterson. Montreal 
1968. 48p. Thesis (M.Sc.(App)) McGill. R D 

FEBRUARY 1969 



March 1969 ,3 v 



-•^^;v 



UMIVERSITY OF OTTAWA, 
SChOOL Of .NUasiWG 
OTTAWA. ONT. 



The 



12-b9-«AC-ll-68 



Canadian 
Nurse 





CNA members face 
serious financial decisions 



infection control 

- a problem for hospitals 

Canada's rare bloodjiank 




_. ■ 



r^. 




Does Jane Cowell know the facts 
about dandruff? 



Probably not! 

The facts are dandruff is a medical prob- 
lem and requires medical treatment. Ordinary 
shampoos cannot control dandruff. 

New formula Selsun can! 

The doctors you know are undoubtedly 
familiar with Selsun. And they prescribe it 
because it's medically recommended. And 
proven effective in 9 out of 10 severe dan- 
druff cases. 

Our new formula Selsun is as effective as 
the old. We use the same efficient anti- 
seborrheic — selenium sulfide. We've simply 
improved the carrier. A more active deter- 




gent produces foamier lather — a finer 
suspension gives smoother consistency. 

To top off new formula Selsun we added 
a fresh clean fragrance and put it in an at- 
tractive unbreakable white plastic bottle. 

If you know someone with a dandruff prob- 
lem tell them to ask their doctor about 
Selsun. And if dandruff worries you — ask 
your own doctor. 



selsun 




(Selenium Sulfide Detergent Suspension U.S. P.) 

A PRODUCT OF ABBOTT LABORATORIES, LIMITED 



GOimnmiini TO GONGKss 




Only three months to go to the 
INTERNATIONAL COUNCIL OF NURSES' 
14th QUADRENNIAL CONGRESS 

Place Bonaventure, Montreal, Canada, 
22 to 28 June, 1969. 



PROGRAM HIGHLIGHTS 

Sunday, 22 June 

3.00 p.m. Interfaith Service 

8.00 p.m. Opening Ceremony 



Monday and Tuesday, 23 and 24 June 
Open meeting of Council of National 
Representatives (CNR) 

Wednesday, 25 June 
"Focus on the Future" 
a.m. Plenary session — 

Forecasting the Future 
p.m. Plenary session — 

Implications of Change 

Thursday, 26 June 

"Focus on the Future" 

a.m. Plenary session — 

Education for Today and To- 
morrow. Basic Programs 

p.m. Plenary session - 

Education for Today and To- 



morrow. Post Basic and Post- 
graduate Programs 

5.00 p.m. Voting for ICN Officers by 
CNR 

8.00 p.m. Students' Congress 



Friday, 27 June 
"Focus on the Future" 
a.m. Plenary session — 

Security for Tomorrow 
p.m. Plenary session — 

Leadership in Action 
8.00 p.m. Closing Ceremony 

Admission of new member 
associations to ICN 
New ICN Officers 
announced 

Saturday, 28 June 
Canada Hospitality Day. 



N.B. * Special Interest Sessions - 19 topics in English and French, will be 
running Monday through Friday 

International Nursing Exhibition - runs Monday through Wednesday 



1ARCH 1%9 



FOR FURTHER INFORMATION, INCLUDING REGISTRATION 
FORMS, PLEASE WRITE TO: 

ICN Congress Registration, 

50, The Driveway, 

Ottawa 4, Ontario. 

N.B.- Advance fee date of $40 extended to 31 March 1969 

THE CANADIAN NURSE 1 



BaiU Oil a Ifiw |i)aii(l(iii()n'. . . 

begin your students' microbiology training with 
this widely adopted text and companion laboratory manual 

New 6th Edition! Smith 

PRINCIPLES OF MICROBIOLOGY 

Your students in this important course deserve this important text! 
Clear, logically oriented discussions communicate the microbio- 
logical foundation they will use in much of their clinical experience: 
concepts of infection, sepsis, digestion, immunity, and other condi- 
tions which play a vital part in their understanding of disease pro- 
cesses. The newly revised 6th edition includes such timely topics as 
DNA and RNA, the body's protective mechanism, and incubation 
periods of communicable diseases. 

By ALICE LORRAINE SMITH, A.B., M.D., F.C.A.P., F.A.C.P., Associate 
Professor of Pathology, The University of Texas Southwestern Medical 
School, Dallas, Tex. Publication date: April, 1969. 6th edition, approx. 672 
pages, 7" x 10". About $10.20. 




New 2nd Edition! 



Smith 



MICROBIOLOGY LABORATORY MANUAL 
AND WORKBOOK 

Twenty-nine exercises give effective progression through a range of 
practical subjects in microbiology. Planned to involve students more 
directly, this revision continues to use the framework of (1) time, 
(2) reference sources, (3) intention, (4) tools, (5) technic, and 
(6) observations. The number of illustrations and tabulations has 
been increased. Pages are perforated and punched. 

By ALICE LORRAINE SMITH, A.B., M.D., F.C.A.P.. F.A.C.P. Publication 
date: May, 1969. 2nd edition, approx. 168 pages, TA" x 10V4" 11 
illustrations. About $4.15. 



A New Boo!<! 



Young-Barger 



By CLARA GENE YOUNG, Technical Editor and 
Writer (Medical), retired, U.S. Civil Service; and 
JAMES D. BARGER, M.D., F.C.A.P., Pathologist, 
Sunrise Medical Center, Las Vegas, Nevada. Pub- 
lication date: January, 1969. 295 pages plus 
FM l-XII, 7" X 10", 11 illustrations. Price, $8.75. 



INTRODUCTION TO MEDICAL SCIENCE 

A basic semi-programmed introduction to the study of disease, this 
unique new book can help all your beginning students and/or para- 
medical trainees gain a broader understanding of how and why dis- 
eases occur, and how they affect the body. It first explains disease as 
a breakdown in body structure or function, indicated by such etio- 
logic factors as neoplasia, hypersensitivity, or heredity; then dis- 
cusses specific diseases commonly met in hospital admission. 



■THE C. V. MOSBY COMPANY, LTD. 

86 Northline Road • Toronto 16, Ontario 



2 THE CANADIAN NURSE 




Publishers 



MARCH 



The 

Canadian 
Nurse 



^ 

^^p 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 65, Number 3 



March 1%9 



25 Thought and Action E. Van Raalte 

27 Infections in the Hospital D. Pequegnat 

30 Idea Exchange 

32 Resources and Use of CNA Library M. Parkin 

35 Canada's Rare Blood Bank L. Carter 

37 A Dollar, A Dollar, Follow the Scholar V. Lindabury 

39 New Services Help Patients and Staff N. Beaudry-Johnson 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

7 News 

17 Names 

18 Dates 



22 In a Capsule 

41 Books 

43 Accession List 

46 Classified Ads 



Executive Director: Helen K. Mussallem • 
Editor: Virginia A. Lindabury • Assistant 
Editor: Loral A. Graham • Editorial Assist- 
ant: Carol A. Kotlarsky • Circulation Man- 
ager: Berjl Darling • Advertising Manager: 
Ruth H. Baumel • Subscription Rates: Can- 
ada: One Year. $4.50; two years, S8.00. 
Foreign: One Year, $5.00; two years, $9.00. 
Single copies: 50 cents each. Make cheques 
or money orders payable to the Canadian 
Nurses' Association. • Change of Address: 
Four weeks' notice; the old address as well 
as the new are necessary, together with regis- 
tration number in a provincial nurses' asso- 
ciation, where applicable. Not responsible for 
journals lost in mail due to errors in address. 
® Canadian Nurses' Association 1969. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for "review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
.Authorized as Second-Class Mail by the Post 
Office Department. Ottawa, and for payment 
of postage in cash. Postpaid at Moiitreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4. Ontario. 



Editorial 



1ARCH 1969 



The fact that the Canadian Nurses' 
Foundation is still light on cash is not 
really news. Ever since the five-year 
grant from the W.K. Kellogg 
Foundation ended in 1967, CNF has 
had its back to the wall. 

There are at least three reasons for 
CNF's present financial plight: first, 
many nurses — particularly those who 
are presently inactive in nursing — 
are unaware of the existence of the 
Foundation; second, too many nurses 
who know about CNF are unconvinced 
of its importance and do not bother 
to join; third, the present membership 
fee of $2 is not enough to cover even 
the secretarial and mailing costs (now 
paid by the Canadian Nurses' 
Association). 

As we see it, the first two causes of 
CNF's predicament must be tackled 
by an intensive, coordinated public 
relations program on a national and 
provincial basis. The paltry number of 
members (1,494 at present) is clear 
proof that a haphazard approach to 
publicity just does not work. 

The answer to the third reason for 
CNF's present dilemma is obvious: 
raise the fee to at least $5. When 
nurses become aware of CNF and its 
importance to the profession, they will 
not object to paying an additional $3. 

The incoming CNF Board of 
Directors will no doubt be encouraged 
by the recent announcement that a 
third provincial nurses' association has 
now pledged annual donations to the 
Foundation. We hope, however, that 
the Board will recognize the need to 
get the Foundation's message across to 
all nurses, and will appoint one or 
more of its members to be responsible 
for an aggressive PR program. 

— V.A.L. 
THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



A new nursing publication 

To increase communication among 
faculties of Canadian university schools 
of nursing, the staff of the School for 
Graduate Nurses, McGill University, has 
decided to sponsor a small newspaper to 
provide a medium for assessing problems, 
posing questions, and describing ideas and 
plans of action by persons concerned 
with university preparation and nursing 
research. 

We invite all faculty to contribute 
articles, but also to respond in critical 
fashion to the ideas presented in the 
proposed paper. In other words, some 
will put forth their views, while others 
will respond with considered and 
thoughtful commentary to provide dia- 
logue on the problems and ideas therein. 

We plan thiee issues of the publication 
in 1969. The format, presentation, and 
distribution of the paper will be simple; 
however, the mailing list will include 
schools and agencies other than those 
classified as university. The School for 
Graduate Nurses will finance the first 
issue, but looks forward to contributions 
for subsequent publications. Please 
address all inquiries to: Nursing Publi- 
cation, School for Graduate Nurses, 
McGill University, 3506 University 
Street, Montreal 112, Quebec. - Moyra 
Allen, Associate Professor of Nursing, 
McGill University, Montreal 

Is nursing really going forward? 

It was with great interest that I read 
Dr. H.K. Mussallem's article "The Chang- 
ing Role Of The Nurse" in the November 
1968 issue of the Canadian nurse. 

Although it was interesting and con- 
tained a lot of forecasting, 1 disagree in 
part with the author. The following 
sentence puzzles me: 

"This may mean that in the next 
decade the practice of nursing could more 
closely resemble the practice of today's 
'family doctor' than of today's nurse." 

A patient, who practically or theoreti- 
cally depends on nurses for his physical, 
physiological, emotional, social, and 
psychological needs, can walk into any 
drug store at any time of the day and buy 
himself a pain reliever, such as Aspirin, a 
laxative, or an antacid. Yet a nurse is not 
allowed to use his or her imagination, 
knowledge, and experience to give an 
Aspirin when a patient has a headache, a 
laxative when constipated, or an antacid 
when indigestion is present. How on earth 
is this nurse going to resemble a family 
4 THE CANADIAN NURSE 



doctor 10 years from now? I am taking 
for granted that the nurse can make sure 
that the patient does not have a gastric 
ulcer, or is not allergic to Aspirin, has not 
had a surgical intervention on his alimen- 
tary tract or other contraindications. 

Dr. Mussallem goes on to say: "If 
certain trends continue, nurses could 
become medical technicians, not nurses." 
I think that this is already the case. With 
the number of changes that are taking 
place, it will certainly not be surprising if 
someday one can become a nurse by 
taking correspondence courses. Nursing is 
becoming more and more theoretical 
because many nursing experts have left 
the hospital setting and disassociated 
themselves completely from patients. 
They buUd beautiful theories for the 
benefit of nurses, and leave the patients 
to nonprofessionals. Some experts have 
spent more time accumulating degrees 
than practicing nursing. 

Hospital schools of nursing in Canada 
are full of instructors who obtained a 
nursing diploma, then rushed to the 
nearest university for a degree - thus 
buying themselves a passport to teach. 
Does three months training as a student 
on a medical, surgical, obstetrical, or 
psychiatric unit qualify any nurse to 
teach future graduate nurses? Is that not 
putting the cart before the horse? Some 
nursing instructors have never been in 
charge even for a few hours. 

I have known nurses from universities 
and nurses from diploma schools. Give 
me anytime nurses from diploma schools. 
1 do not want theory; I want - rather the 
patient wants - practice. 

Has anybody come across the situation 
when a nurse who has developed a good 
primary relation with a patient suddenly 
loses the confidence of that patient when 
she very clumsily performs a nursing 
procedure or applies a dressing? Has 
anyone heard a patient say: "Nurse X is 
ill-mannered or rude, but boy does she 
know her stuff." 

Where are we going to draw the line? 
We want nurses with little practical ex- 
perience, but with a degree, to teach and 
make good practical nurses. Isn't our 
logic faulty? - M.H. Rajabally, S.R.N., 
R.M.N. , Ottawa. 

The patient — another professional 

The article by Carlotta Hacker in the 
January issue entitled "A New Category 
ol Healtli Worker tor Canada? " provoked 
me to raise questions. 



The question of where this worker will- 
stand in the hierarchy of hospital organ- 
ization seems, to Miles Provost and 
Desjardins, to be of little concern. To 
quote: "They look neutrally on the 
suggesfion, seeing the assistant as being 
neither superior nor inferior to the 
nurse." 

I submit that neutrality will be non- 
existent. The doctor's assistant will 
almost immediately become superior to 
the nurses issuing orders for treatment 
and tests. 

The second question is a crucial one. 
This article is well-written, provocative, 
and includes many professional opinions. 
But I would suggest that one "profession- 
al" has been overlooked - the patient. He 
pays a phenomenal sum for health ser- 
vices and he is quite sophisticated and 
professional in his demands. Why not ask 
him what he thinks of another category 
of health worker? - A. Joyce Bailey, 
Reg.N., Toronto, Ont. 

Sacrifice to specialization 

1 am writing with regard to the article 
"A New Category of Health Worker for 
Canada? " published in the January issue. 

"Every stage in transition leading to 
the industrial state has been marked by a 
sacrifice to specialization. Every step has 
moved man away from complete personal 
involvement in the task at hand; instead 
he usually specializes in a part of it," Say 
Rogg and D'Alonzo in Emotions and the 
Job. Although the above quotation deals 
with industry, it can be applied without 
revision to the medical and paramedical 
professions. 

Granted, the explosion of knowledge 
makes it impossible for any one man tc 
possess all knowledge or, in the medical 
profession, take complete responsibility 
for all aspects of a patient's care. How- 
ever, some of the major problems ir 
patient care today stem from the facu 
that there are too many categories o! 
workers attempdng to give care to the 
patient. 

I take particular exception to thf 
terms used by Dr. McKendry in the 
article: "It is demeaning for then 
[doctors] to be doing these tasks." This ii 
where many of the ills of nursing havr 
begun. We have assigned so-called les 
important tasks to auxiliary personnel s( 
that nurses could be freed for apparentlj 
more important duties. This has resulte(4 
in the professional nurse sometimes beinf' 
furthest away from patient contact. It i 

MARCH 196! 




This hand 

was bandaged 

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with 

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TUBULAR 

GAUZE 



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But the Tubegauz method is 5 times 
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Many hospitals, schools and clinics 
are saving up to 50% on bandaging 
costs by using Tubegauz instead of 
ordinary techniques. Special easy- 
to-use applicators simplify ei/e/"/type 
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MRCH 1%9 




hard to believe that doctors now wish to 
put themselves into this dilemma. 

The creation of a new medical worker 
raises a number of questions: 

1. Where will the line be divided between 
unique functions of the doctor and those 
of his assistant? 

2. Could not medical technologists be 
trained in some of the functions the 
doctor wishes performed by this new 
medical assistant? 

3. What will be the relationship between 
the medical assistant and the nurse caring 
for the patient? 

4. How will the doctor and nurse, who 
would be even further separated by this 
medical assistant, communicate? 

5. What or who would prevent a doctor 
from hiring more than one medical as- 
sistant? 

With medicine now looking toward 
family practice and team medicine and 
toward concepts of treatment centers 
where all facilities will be available to 
members of a community who need 
them, it is hoped that the notion of a new 
medical worker will be abandoned and 
that doctors, certainly aware of the neces- 
sity of human contact, wOl attempt to get 
closer to their patients, not further away 
from them. - Alberta Casey, Lecturer, 
Psychiatric Nursing, Ottawa. 

Smoking nurses 

In recent months I was Ul in two 
different hospitals. In the large hospital I 
was impressed with the high calibre of the 
nursing service, and the kindness mani- 
fested by the staff. One is aware that true 
nursing takes into consideration the 
whole person. It is not merely making 
beds and bringing pills at stated intervals. 

Perhaps by coincidence, I saw no 
evidence of nurses smoking in the large 
hospital, but considerable evidence in the 
smaller hospital. Nurses are human 
beings, subject to the same human 
frailties as other members of society, but 
we think of all members of the medical 
profession as "working together for 
health." 

Much has been said recently about the 
hazards of cigarette smoking, and much 
more should be said about alcohol as a 
health, social, and safety problem. 

Is it not true that nurses should be 
paying more attention to the Florence 
Nightingale Pledge to which every nurse 
on graduation solemnly subscribes: "I 
will abstain from whatever is deleter- 
ious ... I will do all in my power to 
maintain and elevate the standards of my 
profession." — Kate E. Watson, Vancou- 
ver. D 



Whenyourddy 






starts at _ 
6 a.m... you're oji 
charge duty.. ^ 
you \/e skimped 
onmea/s...^ 
and on sleep... 
you haven thad^ 
time to hem 
a dress... ^ 
mal(e an apple pie., 
washyourhair.. 
evenpowder f/M 
yournose 
in comfort!^. 

it's time for a change. Irregular hours and meals on-the- 
run won't last. But your personal irregularity is another 
matter. It may settle down. Or it may need gentle help 
from DOXIDAN. 

use 

DOXIDAN* 

most nurses do 







DOXIDAN is an effective laxative for the gentle relief of 
constipation wilhoul cramping. Because DOXIDAN con- 
tains a dependable fecal softener and a mild peristaltic 
stimulant, evacuation is easy and comfortable. 

For detailed information consult Vademecum 
or Compendium. 

HOECHST 

PHARMACEUTICALS 

3400 JEAN TALON W , MONTREAL 301 
DIVISION OF CANADIAN HOECHST LIMITED 

MEMBes 




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ClA.> 



THE CANADIAN NURSE 5 




soft testimony to your patients' comfort 

Your own hands are testimony to Dermassage's effectiveness. Applied by your 
soft, practiced Inands, Dermassage alleviates your patient's minor sl<in irritations 
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned 
skin; relieves dryness, itching and cracking . . . aids in preventing decubitus 
ulcers. In short, Dermassage is "the topical tranquilizer", , . it relaxes the patient 
. . . helps make his hospital stay more pleasant. 

You will like Dermassage for other reasons, too. A body rub with it saves your time 
and energy, Massage is gentle, smooth and fast. You needn't follow-up with 
talcum and there is no greasiness to clean away. It won't stain or soil linens or 
bed-clothes. You can easily make friends with Dermassage— send for a sample! 



Now available in new, 16 ounce plastic container with convenient flip-top closure. 



'A-nAj^ -Y-^u^JLiu a.(UO'~tiiL'tAjL' (jUlitnjy^^.,cs^ 



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6 THE CANADIAN NURSE 




LAKESIDE LABORATORIES (CANADA) LTD. 
64Colgate Avenue • Toronto 8, Ontario 

MARCH ^^m 



lournals' Postal Problems 
Discussed By CNA Board 

Ottawa. - The two journals of the 
Canadian Nurses' Association, L'infir- 
miere camdienne and The Canadian 
Nurse, will continue to be published in 
their present form, at least until the next 
Board of Directors meeting in November, 
even if the money has to be borrowed to 
pay the increased postal rates that come 
into effect April 1. This decision was 
made by the CNA Board after members 
had discussed in detail possible ways to 
modify the present form of the journals. 

One suggestion, that the journals be 
published every second month instead of 
every month, was rejected when it was 
explained that the information in the 
"News" section would be outdated in a 
bimonthly publication, and that con- 
siderable advertising revenue would be 
lost. 

A motion to investigate the cost of 
publishing and mailing one bihngual 
journal in the two languages (in the form 
of a "flip" journal - French material at 
one end, Enghsh material at the other 
end) was withdrawn. The CNA general 
manager, Ernest Van Raalte, pointed out 
that the extra mailing and printing costs of 
a single bilingual journal of 104 pages 
sent to each member would amount to an 
extra 514,921 on top of the $135,000 
increase in mailing rates. 

The CNA Board will discuss this finan- 
cial problem again at its November 1969 
meeting. 

CNA Sets 1970 Salary Goals: 
$7,200 for Diploma Nurses, 
$8,460 for University Crads 

Ottawa, — The national salary goal for 
1970, approved by the Canadian Nurses' 
Association's Board of Directors at its 
meeting February 11-14, aims to close 
the gap between starting salaries for 
registered nurses and starting salaries for 
other professional workers in the 
country. 

The salary goal, as recommended by 
the Committee on Social and Economic 
Welfare, would give the beginning practi- 
tioner of a basic diploma nursing program 
"no less than 57,200 per annum," and 
the beginning practitioner of a baccalau- 
reate program "no less than 58,640 per 
annum." The 1969 national salary goal, 
which was approved by the CNA general 
membership at the biennial meeting in 
1968, recommended that the diploma 
graduate get 56,000 as a starting salary, 
and that the baccalaureate graduate get a 
MARCH 1969 



Orientation Day for New Board Members 




An orientation day for new members of the Canadian Nurses' Association Board of 
Directors and provincial executive secretaries was held prior to the Board meeting 
February 11-14, 1969. M. Geneva Purcell (left), president of the Alberta 
Association of Registered Nurses, and Irene Lecicie (center), president of the New 
Brunswick Association of Registered Nurses, are shown with Lois Graham- 
Cumming, director of CNA's Research and Advisory Services. 



salary "substantially greater." 

In explaining her committee's decision 
to recommend these increased salary 
goals to the Board, chairman Louise Tod 
said that a careful review of salaries paid 
to members of comparable professions in 
Canada had been made by the committee. 
"We found that persons in other pro- 
fessions, such as teaching, were still being 
paid higher starting salaries than nurses," 
Miss Tod said. "As a matter of fact," she 
added, "the salaries paid to nursing order- 
lies in some provinces were very close to 
those being paid to nurses in 1968." 

Miss Tod pointed out that a 1967 
survey conducted by the Department of 
Manpower and Immigration showed that 
starting salaries of nurses with university 
education were at the bottom of the list 
of 55 named professions. "If we are to 
attract suitable persons into nursing and 
retain them, we must bring nurses' 
salaries in line with those of other pro- 
fessionals," she said. 

Other policies recommended by the 
Committee on Social and Economic 
Welfare and approved by the Board are: 
• That in the inteiest of quality patient 

care, social recognition and economic 



reward should be given those nurses 
who become expert nurse practi- 
tioners. 

• That the CNA recommend to provin- 
cial nurses' associations that manage- 
ment nurses be encouraged to utilize 
existing legislation or, if necessary, 
that the provincial organization seek 
further legislation or alternate meth- 
ods to represent effectively nurses 
whose function is deemed to be mana- 
gerial. 

• That the Board of Directors initiate a 
study of all federal legislation that has 
implications for nursing and nurses, 
and any necessary action be imple- 
mented to effect changes. 

These revised goals on Salary and 
Employment Standards, along with new 
Social Welfare Goals approved by the 
Board, are to be published as a separate 
document in 1969, and will be available 
on request to all CNA members. 

The Social and Economic Welfare 
Committee, which held one meeting in 
the 1968-70 biennium, will meet again in 
Ottawa early in 1970, with the em- 
ployment relations officers of the pro- 
vincial associations. 

THE CANADIAN NURSE 7 




CNA Testing Service 

To Be Located In Ottawa 

Ottawa. -The Canadian Nurses' As- 
sociation Testing Service will be located 
in Ottawa. This decision, based on a 
recommendation of the CNA Executive 
Committee, which had investigated 
physical facihties for the Service in Otta- 
wa, was approved by the CNA Board of 
Directors at its meeting February 11-14, 
1969. 

CNA becomes the official owner of 
the testing service May 1, 1970, when it 
takes over the existing testing service of 
the Registered Nurses' Association of 
Ontario, At present, a liaison committee, 
composed of the 10 provincial registrars, 
is working closely with the director of the 
RNAO Testing Service, Dr. Dorothy 
Colquhoun, to facilitate present planning 
for test development. 

The CNA Board considered whether 
the new national testing service should be 
incorporated, that is, have its own Letters 
Patent and be set up as an independent 
body similar to the Canadian Nurses' 
Foundation, or whether it should be 
under the control of the CNA Board of 
Directors. Board members agreed that the 
testing service should eventually be set up 
under an independent board. 

The CNA Board agreed to defer the 
final decision until its meeting November 
3-7, 1969, at which time Board members 
will be asked to discuss the terms of 
reference for a provisional board. 

Considerable discussion centered on 
the need to give instruction in item 
writing and test construction to nurse 
educators throughout the country. The 
Board agreed that this responsibility rest- 
ed primarily with the provinces, and that 
CNA would set up self-supporting work- 
shops only if necessary. 



Special CNA Meeting 
To Be Held This Year 
To Consider Bylaws 

Ottawa. —A Special Meeting of the 
Canadian Nurses' Association will be held 
sometime during the week of November 
3, 1969, to consider amendments to the 
Association's bylaws. 

This decision was made by the CNA 
Board of Directors at its meeting Fe- 
bruary 11-14, after Board members 
expressed concern about any further 
delay in obtaining the issuance of Letters 
Patent for the Association under the 
Canada Corporations' Act. Without this 
special general meeting, CNA would have 
to wait until the regular general meeting 
in June 1970 to have the bylaws ap- 
proved by membership. 
8 THE CANADIAN NURSE 



UBC Celebrates Golden Jubilee 




Vancouver. -The University of British Columbia honored the Golden Jubilee of its 
School of Nursing and the memory of its first nurse director, the late Ethel Johns, 
LL.D., on January 12 at a ceremony presided over by UBC Chancellor John M. 
Buchanan. Elizabeth McCann, acting director of the School of Nursing, paid tribute 
to the School's first three directors, Ethel Johns, Mabel F. Gray, and H. Evelyn 
Mallory, and described the growth of the school from its first three students in 
1919 to its present graduating class of 97. 

Dr. Rae Chittick, professor emeritus, McGill University, deUvered a tribute to 
Miss Johns, before Professor Margaret Street (left), presented a collection of medals 
and medaUions to Basil Stuart-Stubbs (right). University librarian. The medals and 
medallions were Miss Johns' gift to the Charles Woodward Memorial Room. The 
ceremony was attended by representatives of the facuhy and Nursing Under- 
graduate Society, and hospitals and organizations from Vancouver. A reception was 
held afterward, and exhibits prepared by the hbrary staff were viewed. 



The approval of bylaws will be the 
only item considered at the special gen- 
eral meeting in November. Each province 
will be entitled to a number of votes 
based on membership, and will assign 
these votes to one or more delegates. 

Board members were brought up-to- 
date on CNA's progress in applying for 
Letters Patent under the Canada Corpora- 
tions' Act by Gordon F. Henderson, Q.C., 
legal adviser for CNA. Mr. Henderson said 
that it is the Association's obligation now 
to satisfy the Department of Consumer 
and Corporate Affairs that the CNA 
bylaws comply with the requirements of 
Letters Patent companies. 

"The one item that constitutes a 
change of some substance," Mr. Hender- 
son said, "is the change dealing with 
withdrawal from membership in the Asso- 
ciation. At present," he added, "the 
corporate structure of CNA is worded in 
such a way that the provinces named are 
members, and there is no provision for 
withdrawal for member associations. This 
bylaw on withdrawal must be added," he 
explained, "to comply with the Canada 



Corporations' Act's requirements for 
Letters Patent companies." 

Other bylaw amendments of a more 
formal nature will also be required, Mr. 
Henderson said. 

A copy of the old bylaws and the 
proposed bylaws will be sent to the 
provincial nurses' associations in mid- 
April for study by their legislative and 
bylaw committees. The final draft of the 
bylaws will be sent to the provincial 
associations at least two months ahead of 
the special general meeting in November. 

Board Approves Revised 
Continuing Education Statement 

Ottawa. -The revised statement on 
continuing education prepared by the 
Committees on Nursing Education and 
Nursing Service of the Canadian Nurses' 
Association was accepted by the CNA 
Board at its meeting February 1 1-14. 

The original statement had been refer- 
red back to the committees for restate- 
ment and clarification by the CNA Gen- 
(Continued on page 10, 
MARCH 1%S 




WHO NEEDS 

Aspirators? 



Every hospital needs these time- 
tested, precision built aspirators for post- 
operative work, urological and broncho- 
scopic suction, removal of mucus from 
the throats of newborn and general bed- 
side suction. 

Gomco 789 shown in use weighs only 16 
pounds, is easily carried, requires less than 
1 sq. ft. of space. 

Gomco 799 stand-mounted unit shown left. 
Large capacity vacuum bottle. Mobile, easy 
to move about. 

Gomco 796 cabinet Aspirator — just right 
for Recovery, Nursery, Out-Patient, Emer- 
gency, and Dental Clinic. 

Not shown — Gomco 791 stand-mounted 
Aspirator and 792 portable — both with 
o" to 25" vacuum, and Gomco 790 stand- 
mounted O" to 20" vacuum. 

See your dealer, or for newest catalog, 
write: GOMCO SURGICAL MANUFAC- 
TURING CORP., 828 E. Ferry St., Buffalo, 

New York 14211 
D*pt. c-a J 



lU lf>ME NT 



(Continued from page 8) 
eral Meeting of July 1968. The revised 
statement will appear in a future issue of 
The Canadian Nurse. 

The Board also agreed to a recom- 
mendation from the Nursing Service 
Committee that CNA's Social and Eco- 
nomic Welfare Committee be asked to 
consider: what social or financial re- 
cognition could be given to nurses giving 
excellent performance versus those giving 
average performance; and ways to main- 
tain standards of care when collective 
bargaining agreements are drawn up. 

The Committee met at CNA House 
January 14 to 16 under the chairmanship 
of Margaret McLean. 

Board Approves 

Nursing Education Motions 

Ottawa. - The Board of Directors of 
the Canadian Nurses' Association will 
make efforts to initiate dialogue between 
the allied health professions on the ques- 
tion of proliferation of categories of 
health workers, with a view to formula- 
ting a policy statement. 

This decision was taken on a recom- 
mendation by CNA's Committee on Nurs- 
ing Education, made at the Board meet- 
ing February 11 to 14. The Board also 
agreed to the following motions made by 
the Committee: 

• The regulation of entry into the nurs- 
ing profession, including approval of basic 
nursing programs, must rest with the 
legally constituted professional nursing 
body in each province. This move was felt 
necessary since diploma schools of nurs- 
ing are moving into the general educa- 
tional stream, and concern has been 
expressed as to whom has the legal 
authority to approve programs in these 
cases. 

• Since some activities of non-nursing 
personnel affect the welfare of those 
receiving nursing care, nurses should col- 
laborate in educational programs for such 
workers. 

• Those students studying nursing in 
university programs should receive 
priority in the use of hospital and health 
agency experience until CNA's recom- 
mended ratio of two categories of nurse 
practitioners is reached. This ratio is one 
graduate of a baccalaureate program in 
nursing for every three diploma program 
graduates. At present, some 94 percent of 
working nurses in Canada hold diplomas; 
the remaining six percent have degrees. 

The Nursing Education Committee 
met prior to the Board meeting, January 
21-23, under the chairmanship of 
Kathleen Arpin. 
10 THE CANADIAN NURSE 




Winnipeg. - Manitoba Lieutenant Governor Richard S. Bowles officially opened 
the new headquarters of the Manitoba Association of Registered Nurses January 17. 
Some 80 official guests watched as Lillian Pettigrew, associate executive director, 
Canadian Nurses' Association, unveiled a cornerstone marking the occasion. Miss 
Pettigrew is seen above (right) with Dorothy Dick, MARN president. 

Miss Pettigrew, for many years MARN executive secretary, said, "This fine 
building identifies the vitality of the profession in Manitoba and bears testimony to 
the faith of nurses in the permanence of their services. May the facilities of this 
handsome headquarters inspire their efforts and assure their success." 

Items of historical interest to nursing were placed behind the cornerstone, to be 
opened in 100 years. Included were biographical sketches of MARN's honorary 
members. 

Greetings were extended by Alderman Inez Trueman, from the City of 
Winnipeg; Thomas B. Findlay, Counsellor of the MetropoUtan Corporation of 
Greater Winnipeg; Dr. R.H. Tavener, from the provincial health ministry; and 
Labour Minister C.H. Witney, representing Manitoba Premier Walter Weir. 



Mailing Charges Both Ways 
On CNA Library Loans 

Ottawa. -As a result of increased 
postal rates, the Canadian Nurses' As- 
sociation's library will now require all 
borrowers to pay mail charges both ways. 
The decision was made by the Board of 
Directors at its meeting February 11-14, 
1969 and will be effective April 1, 1969. 

Payment of mailing charges both ways 
has always been a requirement under the 
formal inter-library loan agreement. This 
requirement has not previously been ex- 
tended to individual or institutional bor- 
rowers who do not use the standard 
inter-library loan forms. Now, in addition 
to paying the return postage, all bor- 
rowers will be expected to refund, in 
postage, the cost of mailing library ma- 
terial to them. 

Draft Standards To Be Tested 

Ottawa. —The present draft standards 
drawn up by the Ad Hoc Committee on 



Standards for Nursing Service of the 
Canadian Nurses' Association will be test- 
ed in selected areas before final revision. 

CNA Board of Directors, meefing 
February 11 to 14, agreed to a plan for 
testing these standards laid out in a 
progress report by Committee Chairman 
Irene Buchan: approval of areas selected 
for testing will be sought; draft standards 
will be forwarded; and each committee 
member will be assigned to a particular 
area for necessary discussion. 

Purpose of the testing is to determine 
whether these standards are concise, ap- 
plicable, reliable, etc. Comments from 
testing areas will be used in the final 
revision. 

The draft standards are in the form of 
a self-evaluation guide, since the final 
standards are planned as a tool for use by 
nursing administrators in all nursing ser- 
vices in evaluating and improving the 
quality of nursing service. 

(Continued on page 12} 
MARCH 1969 




when teen-agers want to know about menstruation 
one picture may be worth a thousand words 



Never are youngsters more aware of their own 
anatomy than when they begin to notice the changes 
of adolescence. And never are they more susceptible 
to misinformation from their friends and schoolmates. 

To negate half-truths, give teen-agers the facts — 
using illustrations from charts like the one pictured 
above. They'll help answer teen-agers' questions about 
anatomy and physiology. These SVa" x 11" colored 
charts of the female reproductive system were pre- 
pared by R. L. Dickinson, M.D. and are supplied free by 
Canadian Tampax Corporation Ltd. Laminated in 
plastic for permanence, they are suitable for grease 
pencil marking. And to answer their social questions 
on menstruation, we also offer two booklets — one 
for beginning menstruants and one for older girls — 
that you may order in quantities for distribution. 

Tampax tampons are a convenient — and hygienic 
— answer to the problem of menstrual protection. 
They're convenient to carry, to insert, to wear, and 
to dispose of. By preventing menstrual discharge from 
exposure to air, Tampax tampons prevent the embar- 
rassment due to menstrual odor. Worn internally, they 

MARCH 1%9 



cause none of the irritation and chafing associated 
with perineal pads. 

Tampax tampons are available in Junior, Regular 
and Super absorbencies, with explicit directions for 
insertion enclosed in each package. 

TAMPAX 

SANITARY PROTECTION WORN INTERNALLY 

MADE ONLY BY CANADIAN TAMPAX CORPORATION LTD.. BARRIE. ONT. 

FREE CHARTS IN COLOR 

Canadian Tampax Corporation Ltd.. P.O. Box 627, Barrie, Ont. 

Please send tree a set ot the Dickinson charts, copies of the 
two booklets, a postcard for easy reordering and samples of 
Tampax tampons. 



Name_ 



Address. 



THE CANADIAN NURSE 11 



Next Month 



in 



The 

Canadian 
Nurse 



• Screening Program for 
Cancer of the Cervix 

• Hemodialysis in the Home 

• Calculating Your Income Tax 




^Z7 



Photo credits for 
March 1969 



Crombie McNeill Photography, 
Ottawa, p. 7 

University of British Columbia, p. 8 

David Portigal & Co. Ltd., 
Winnipeg, p. 10 

Peter Bregg Photographer, 
The Canadian Press, p. 17 

St. Michael's Hospital, Toronto, 
pp. 30, 31 

Tara Dier, Ottawa, pp. 32, 33 

Tom Bochsler Photography, 
Hamilton, p. 38 

Ed. Bermingham Inc., Montreal, 
p. 40 



(Continued from page 10) 

This guide will include areas on: philo- 
sophy; objectives; functional structure of 
the nursing department; personnel, 
material resources; and the nursing de- 
partment within the total organization. 

CNF Elects New Board, 
Ponders Financial Problem 

Ottawa. -Members at the annual 
meeting of the Canadian Nurses' Founda- 
tion elected a new Board of Directors to 
serve a two-year term — then briefly 
reviewed some of the problems that the 
new Board will have to face. 

Elected to the Board were: Jean 
Church, Dorothy Dick, E. Louise Miner, 
M. Geneva Purcell, and Albert W. 
Wedgery from the Board of Directors of 
the Canadian Nurses' Association; and 
Alice Beattie, Sister Marie Bonin, Hester 
J. Kernan, and Marion C. Woodside from 
the membership-at-large. The new presi- 
dent and vice-president will be elected 
from the board at its first meeting. 

Few solutions were proposed for the 
Foundation's financial ills. This year, 
members had to vote to transfer $10,000 
from the general membership fund into 
the scholarship fund to provide at least 
$25,000 for awards. This is about one- 
half the amount awarded in 1967 or 
1968. 

"Any moneys raised before awards are 
given in May would, of course, be added 
to the funds," retiring president M. Jean 
Anderson reported. 

Other suggestions to promote interest 
in CNF and to raise money were dis- 
cussed during the meeting and will be 
taken to the Board for decision. 

Members approved a suggestion from 
the retiring Board that baccalaureate 
awards again be deferred (for 1969-70) as 
funds are so low. 

One member suggested that CNF 
should plan more and better promotion 
and publicity campaigns. Miss Anderson 
reviewed what had been done during the 
past year and added that she hoped that 
the provinces would undertake more res- 
ponsibility in this area. Miss Anderson 
added that the Board is considering a 
promotion campaign to let nurses know 
how they may leave money to the Foun- 
dation in their wills. "We believe that 
many nurses do not know that they can 
do this, or know how to go about it," she 
said. 

A suggestion that the CNF meeting be 
held concurrently with the CNA meeting 
was made by one member-at-large. She 
added that this might promote more 
interest among nurses. This year's annual 
meeting was held February 1 1 during the 



12 THE CANADIAN NURSE 



week of the CNA Board meeting so that 
representation from all provinces would 
be assured. About 35 of the 1,494 mem- 
bers attended. Only 16 members had 
attended the previous annual meeting. 

A suggestion that membership fees be 
raised from $2 to $5 was discussed and 
several members suggested it would not 
be feasible at this time. "We need a large 
volume of members - and we'll never 
attract them by raising the fees," was one 
comment. 

The new Board will meet within the 
next few weeks to consider these matters. 

ANPQ Donates $50,000 
To ICN Congress 

MontreaL-A gift of $50,000 has been 
donated by the Association of Nurses of 
the Province of Quebec to the XIV 
Quadrennial Congress of the International 
Council of Nurses, to be held June 22-28 
in Montreal. 

The decision to donate the money was 
made by the Committee of Management 
of the ANPQ in October, 1968, but the 
gift was not announced until mid-January 
when the cheque was received by Helen 
K. Mussallem, executive director of the 
Canadian Nurses' Association. According 
to Helena F. Reimer, secretary-registrar 
of the ANPQ, the gift was made for four 
reasons: the heavy costs of the ICN 
Congress; the fact that the ICN president, 
Alice Girard, is a member of the ANPQ, 
and that the Congress is to be held in 
Montreal; and because the ANPQ is a 
member of the CNA. 

Dr. Mussallem thanked the ANPQ for 
the donation, commenting, "This tangible 
evidence of support is heartwarming to 
those who bear the responsibility for the 
execution and financing of the large 
international convention." 

ICN Registration Deadline 
Extended To March 31 

Ottawa. -The deadhne for the $40 
registration fee for the 14th Quadren- 
nial Congress of the International Coun- 
cil of Nurses has been extended to 
March 31 from January 22, according to 
Harriet J.T. Sloan, ICN Congress 
Coordinator. 

The extension of the deadline is due 
to delays in transmittal and processing 
of registration forms, Miss Sloan said. 
The fee for registration after March 31 
will be $60. 

The completed registration, together 
with the necessary money, must be 
received at CNA House, 50 The Drive- 
way, Ottawa 4, by March 31 to qualify 
for this advance fee. 

The completed registration, together 
with the necessary money, must be 
received at CNA House, 50 The Drive- 
way, Ottawa 4, by March 31 to qualify 
for this advance fee. 

MARCH 1%9 



news 



Curriculum Conferences Held 
in Vancouver and Victoria 

Ottawa.-Two conferences on curric- 
ulum construction, sponsored by the 
Registered Nurses' Association of British 
Columbia, were conducted last month by 
Sliirley R. Good, consultant in higher 
education, Canadian Nurses' Association. 
The first was held in Vancouver February 
3 and 4, and the second in Victoria, 
February 6 and 7. 

"The request from RNABC was for a 
conference dealing with curriculum as it 
relates to concepts and principles," Dr. 
Good told The Canadian Nurse. To deal 
with this question. Dr. Good compared 
the construction of curricula to con- 
struction of buildings, and divided her 
theme "Highrise for Curricula" into five 
sections. 

The first section, "selection of site," 
.considered the question of how a person 
thinks, and the thought process. Critical 
thinking was dealt with in the second 
section, "concrete foundations." "Tools 
of the trade" differentiated between con- 
cepts and principles, and "windsway fac- 
tor" dealt with concepts, definitions, and 
statements of concepts. The final section, 
"staircases," considered the design of a 
nursing curriculum based on these ideas. 

Throughout the conference, partic- 
ipants divided into small groups to con- 
sider vignettes presented for discussion. 
They were asked to identify nursing 
knowledge, the principles inherent in the 
knowledge, and the basis for nursing 
judgment and action. 

Participants included instructors of 
nursing assistants and psychiatric nurses, 
as well as instructors in diploma and 
university schools of nursing. 

ICN Registration Triples 

Ottawa, -Canadian registration for the 
Congress of the International Council of 
Nurses to be held in Montreal has almost 
tripled since January 10, 1969. As of 
February 10, 2,145 Canadians had regis- 
tered for the June 1969 Congress, nearly 
1,400 more than one month earlier. On 
January 10, Harriet J.T. Sloan, ICN 
Congress Coordinator, reported that 756 
Canadians had registered for the inter- 
national meeting. 

Breakdown of registration up to Feb- 
ruary 10, 1969 is: 

British Columbia 98 

Alberta 126 

Saskatchewan 38 

Manitoba 68 

Ontario 693 

Quebec 802 

Nova Scotia 53 

New Brunswick 107 

Prince Edward Island 13 

MARCH 1969 



Newfoundland 

Students 
Total 



10 



2,008 
137 



2,145 



Alberta And British Columbia 
Announce Contributions To ICN 

Ottawa, —The Alberta Association of 
Registered Nurses and the Registered 
Nurses' Association of British Columbia 
recently announced contributions to the 
International Council of Nurses XIV 
Quadrennial Congress to be held in 
Montreal June 22-28. 

The AARN will donate S7,000 and the 
services of its public relations officer, 
Donald LaBelle, for the duration of the 
Congress. The Association is also planning 
a hospitality luncheon at which AARN 
members will entertain a representative of 
each international association attending 
the Congress. The provincial council of 
AARN is providing funds to district 
executives to assist in defraying costs of 
members attending the Congress. 

The RNABC will also donate the 
services of its public relations officer, N. 
Fieldhouse, for the Congress, and $5,000 
toward the cost of holding the Congress. 
The Association will pay the living ex- 
penses of RNABC staff at the Congress, 
and of six nurse hostesses from BC. It wiU 
also donate 12,000 Canadian flags and a 
number of copies of the publication 
Beautiful BC. Another $500 will be 
donated to provide music for the Con- 
gress. 

SRNA Announces 
Annual CNF Donation 

Ottawa. -The Saskatchewan Regis- 
tered Nurses' Association recently an- 
nounced that a contribution of $1. per 
member will be given annually to the 
Canadian Nurses' Foundation, commen- 
cing this year. 

This brings to three the number of 
provincial nurses' associations that have 
pledged annual contributions to CNF: the 
Registered Nurses' Association of British 
Columbia, the Alberta Association of 
Registered Nurses, and SRNA. 

At the CNF annual general meeting 
February 1 1 in Ottawa, president M. Jean 
Anderson noted that small group dona- 
tions from Alberta, British Columbia, and 
Saskatchewan have increased in number, 
probably because nurses in these pro- 
vinces are more aware of the Founda- 
tion's needs. 

Special Sessions 

For ICN Congress Registrants 

Ottawa — Nineteen special interest 
and clinical sessions will be presented 
during the 14th Quadrennial Congress of 
the International Council of Nurses in 
Montreal, June 22-28, 1969. According 
to ICN Congress Coordinator Harriet J. T. 



V\m QUAlin PRODUCIii 




POSEY HEEL PROTECTOR 

(Patent Pending) 
The Posey Heel Protector serves to protect 
the heel of the foot and prevents irritation 
from rubbing. Constructed of slick, pliable 
plastic, lined with synthetic wool. Con be 
washed or autoclaved. No. HP-63ALW. 
$3.90 ea. — $7.80 pr. (w/out plastic shell) 
$5.25. 



NO. 66 

POSEY SAFETY 

BEIT 

(Potent Pending) 



of potlvnti 




This new 
Posey Belt 
provides safe- 
ty to o bed 
patient yet 
permits him 
to turn from side to 
side. Also allows sitting 
up. Mode of strong, re- 
inforced white cotton 
webbing; with flonnel-lined canvas reinforced 
insert. Strap posses under bed after a turn 
around spring roil to anchor. Friction-type 
buckles. Buckle is under side of bed out of 
patient's sight and reoch. Also ovoiloble 
in Key-Lock model which attaches to each 
side of bed. Small, medium and large 
sizes. No. 66. $8.25. Key-Lock Belt, No. 
K66, $13.95. No. 66-T. (ties on sides of 
bed) $8.tO. 




POSEY SAFETY BELT 

(Patented) 
Allows maximum freedom with sofe re- 
straint. An improvement over sideboards, 
the Posey belt is designed to be under the 
patient and out of the way. Belt and bed 
strap ore of heavy white cotton webbing; 
loop and pod of cotton flannel. Friction-type, 
rust-resistant buckles. Small, Medium ond 
Large sizes. Safety Belt, No. S-141, $6.90. 
(Extra heavy construction with key-lock 
buckles. No. 453, $19.80) 



POSEY PRODUCTS 
Stocked in Canada 

ENNS & GILMORE LIMITED 

1033 Rangeview Road 
Port Credit, Ontario, Canada 



THE CANADIAN NURSE 13 




Sloan, most of the 19 sessions will be 
presented in English and French beginning 
Monday June 23 and ending June 27. 

Topics for the special interest sessions 
include: leadership and management; use 
of computers in nursing service adminis- 
tration; audiovisual media in nursing 
education; the printed word (learning the 
writer's skills); nursing journaHsm; 



libraries in schools of nursing and for 
professional associations; forming and 
developing the national association; nurs- 
ing legislation; and nursing research. 

Topics for the clinical sessions include: 
continuity of patient care; nurses and the 
practice of nursing; psychiatric and 
mental health nursing; implications for 
nursing practice for patients with heart 
surgery; outpost nursing; implications for 
nursing practice with patients with renal 
transplantations; occupational health; 
emergency health preparedness; rehabil- 
itation; and space age nursing. 



F 



at 
your 
fingertips... 





secure 

umbilical cord 
ligation 

\ 

When it's time to ligate the umbilical cord, a Hollister 
Double-Grip^" Cord-Clamp should be within reach. Its 
contoured finger-grips and wide jaw angle make one- 
hand application easy. 

Hollister's Cord-Clamp has other benefits too: a hinge 
guard to keep even a large cord within the sealing area; 
firm-holding Double-Grip jaws to prevent slipping; a 
constant, even pressure to eliminate the dangers of seep- 
age; and no need for belly bands or dressings. The clamp 
has a permanent, blind closure. When it's ready for re- 
moval—usually after 24 hours— the clamp is simply cut 
through at the hinge. Hollister provides the clipper. 

This disposable, lightweight Hollister Cord-Clamp may 
be autoclaved, or it can be purchased in individual pre- 
sterilized packets. Write for samples and literature, on 
hospital or professional letterhead, please. 



Q 



HOLLISTER 

IN CANADA: 160 BAY ST.. TORONTO I. ONT. 



211 L CHICAGO AVE., CHICAGO, ILL. eOCII 



14 THE CANADIAN NURSE 



NBARN Presidents' Conference 

Fredericton, -"The Chapter Chain - 
Improvement Through Involvement" was 
the theme of the seventh Presidents' 
Conference held January 22-23 by the 
New Brunswick Association of Registered 
Nurses. Twenty-one presidents and vice- 
presidents representing the 1 1 chapters in 
the province attended the sessions, held 
at NBARN headquarters. 

Purposes of the conference were two- 
fold: to assist present and future chapter 
presidents in carrying out their respon- 
sibilities of office; and to provide an 
opportunity for chapter leaders to meet 
and discuss common problems and ex- 
periences. 

The program covered several areas of 
chapter programming, including chapter 
bylaws, executive committees, standing 
committees, program and finance com- 
mittees. Problem-solving situations, a skit, 
and group discussion were among the 
methods of presentation. 

Other items discussed were: NBARN 
Act and By-Laws, job responsibilities of 
provincial office staff, the new Public 
Service Labour Relations Act, the 14th 
Quadrennial Congress of the International 
Council of Nurses and the 1970 General 
Meeting of the Canadian Nurses' Asso- 
ciation, to be held in Fredericton. 

PEI Nurses Granted 
Salary Increases 

Charlottetown, PEI. —Prince Edward 
Island nurses working in hospitals finan- 
ced by Hospital Insurance have been 
granted a salary increase raising their 
basic salary from $326 to $396 per 
month. The increase was effective Jan- 
uary 1, 1969. 

The increase falls short of the original 
demands of the nurses: a 10 percent 
increase retroactive to January 1, 1968, 
and a further 15 percent increase effec- 
tive January 1, 1969. This would have 
brought the basic salary to S424 per 
month. The nurses had been threatening 
mass resignations previous to the settle- 
ment. 

Under the new terms, nurses would 
reach a maximum salary of $458 in four 
years, or in four increments. In the past 
there had been five increments. 

Nurses working for provincial govern- 
ment hospitals and agencies are expecting 
a similar increase, possibly retaining the 
five increments. Their increase will be 
effective April 1, 1969. 

The basic salary for nursing assistants 
has been increased to $250 with five 
increments to a maximum of $357 per 
month. 



Community College in Ontario 
To Start Nursing Program 

Toronto. -In September 1969, 
Humber College of Applied Arts and 

MARCH 1%9 




Technology will become the first com- 
munity college in the province to add a 
two-year diploma nursing course to its 
curriculum. 

The program, developed by Humber 
College and St. Joseph's Hospital School 
of Nursing, wUl be similar to the program 
presently being carried out at St. 
Joseph's. 

Students who enroll in the College 
program will use the clinical facilities at 
St. Joseph's Hospital and Etobicoke Gen- 
eral Hospital, when the latter is complet- 
ed. Annual tuition fees will be SI 85 plus 
the cost of books, uniforms, and labo- 
ratory fees. Students will have six weeks 
vacation annually. 

In an interview with The Canadian 
Nurse, Albert Wedgery, president of the 
Registered Nurses' Association of On- 
tario, commented favorably on Humber 
College's plans. 

"This announcement is an encouraging 
sign of changing attitudes about the kind 
of preparation that nurses need to func- 
tion properly in today's complex 
society," Mr. Wedgery said. "With other 
Canadian provinces having moved, or 
about to move, their diploma programs in 
nursing into the stream of general educa- 
tion, this new opportunity at Humber 
College anticipates a similar, but gradual, 
development in Ontario. Perhaps the 
most enlightening aspect of this proposed 
program," he continued "is the fact that 
a hospital school of nursing, with a long 
and notable history, has decided to merge 
into an educational system that provides 
a broader professional base for nursing 
practice." 



Collective Bargaining Workshops 
'Held Across Manitoba 

Ottawa.— A series of special educa- 
tional workshops on collective bargaining 
is being held across Manitoba, sponsored 
by the employment relations committee 
of the Manitoba Association of Register- 
ed Nurses. The series runs February 1 7 to 
March 13. 

Conducting the workshops is Glenna 
Rowsell, consultant in social and econ- 
omic welfare for the Canadian Nurses' 
Association, assisted by MARN staff and 
members of the employment relations 
;ommittee. 

Two workshops are being held in 
Winnipeg, the others in Swan River, 
Dauphin, Flin Flon, Morden, Russell, and 
Brandon. Aim of these workshops is to 
Jiterpret to MARN members; clarifi- 
;ation of collective bargaining; the func- 
ion of a professional association in col- 
ective bargaining; the responsibility of 

vlARCH 1%9 



individual members; and the effects of 
working under a collective agreement. 

New Brunswick Nurses 

To Be Granted 

Collective Bargaining Rights 

Fredericton. —Some 3,600 New Bruns- 
wick nurses were among 30,000 public 
service employees recently granted full 
collective bargaining rights in the Pubhc 
Service Labour Relations Act, passed 
December 4, 1968 by the New Brunswick 
Legislature. Prior to this, only 20 percent 



of the public service employees had 
collective bargaining rights. Nurses were 
among those excluded. 

The new Act, which comes into effect 
on a date fixed by proclamation, forbids 
employees to picket, parade, or dem- 
onstrate, and forbids the employer to 
replace striking employees. When nego- 
tiation fails, the employees have the 
choice of arbitration or strike action with 
provision for continuation of essential 
services if strike action is chosen. 

Under the Act, employees are divided 
into four categories. The majority of 
nurses are included under the category of 



TO PLAN FOR A LIFETIME 





Marriage is a respontibilitY ')«>' often re- 
quires both spirituol and medicol assistance 
from professional people. In many instances 
a nurse may be called upon for medical 
counsel for the newly married young wo- 
man, motheff or a mature woman. 

"To Plan For A Lifetime, Plan With^Your Doc- 
tor" is a pamphlet that was written to assist 
in preparing a woman for patient-physician 
discussion of family planning methods. The 
booklet stresses the importance to the indi- 
vidual of selecting the method that most 
suits her religious, medical, and psychological 
needs. 



Nurses are invited to use the coupon below 
to order copies for use as an aid in coun- 
selling. They will be supplied by Mead John- 
son Loboratories, a division of AAead John- 
son Canada Ltd., as a free service. 



MeadjiJiTiMn 

LABORATORI ES 



n 



ORDER FORM To: Mead Johnson Laboratories, 

95 St. Clair Avenue West, 
Toronto 7, Ontario. 

Please send copies of "To Plan For A Lifetime, Plan With Yeui 

Doctor" to; 



Nome 
Address 



l_ 



THE CANADIAN NURSE 15 




hospital board employees. A small 
number of nurses are in another category 
that includes civil servants. The govern- 
ment Treasury Board has been designated 
as the employer for these groups for 
purposes of the Act. 

The Act authorized the establishment 
of a Public Service Labour Relations 
Board, to be an independent body 
responsible for supervision of the in- 
terests of employees and employers, and 
safeguarding the interests of the public. A 
Public Service Arbitration Tribunal, con- 
sisting of a chairman and representatives 
from labor and management, will also be 
established. 

The Act specifies that the collective 
bargaining will begin with a 45-day 
negotiation period. If no agreement is 
reached, a conciliation officer must file a 
report within 14 days. At the same time 
the employer submits to the Public 
Service Labour Relations Board a list of 
individual employees and work categories 
required to maintain essential services; 
the union may contest these designations, 
but the final decision rests with the 
Labour Relations Board. 

After the conciliation officer's report, 
1 5 days are allowed for the estabUshment 
of a conciliation board; this board is given 
30 days to make its report. At this time 
either party may request that the Public 
Service Labour Relations Board declare a 
deadlock. After the chairman is satisfied 
that a deadlock exists, he has three days 
to declare it and to see if the parties will 
submit their disagreements to arbitration. 
If they agree to arbitration, both groups 
must submit statements on the points of 
disagreement to the arbitration tribunal 
within 14 days. Work continues during 
this period. If both parties do not agree 
to arbitration, the employees' bargaining 
unit may hold a strike vote. 

The New Brunswick Association of 
Registered Nurses called the Act "fair and 
reasonable." The Association is prepared 
to apply for certification as a bargaining 
agent as soon as possible under the new 
Act. 



Workshops On Test Construction 
To Be Held in London 

London, Onf. -Vivian Wood, assistant 
professor of nursing at the University of 
Western Ontario, will conduct a work- 
shop on test construction at the Uni- 
versity May 5-7. 

The workshop will concentrate on a 
discussion of measurement, exploration 
of examination blueprint models, and 
essay and objective examinations. Partic- 
ipants will be developing skills in writing 

16 THE CANADIAN NURSE 



essay questions, developing blueprints for 
examinations, preparing model essay 
answers, and marking essay answers. 
Skills in item-writing and item-analysis 
will also be discussed, and the final 
assessment of students will be explored 
by examining the various models in 
grading. 

Cost of the course is $75, plus $7 per 
night for accommodation. The course is 
limited to 30 people. 



1969 Fee$ Are Due 

Ottawa. - Nurses in four provinces 
will pay more for membership in their 
provincial associations in 1969, accord- 
ing to Ernest Van Raalte, general 
manager of the Canadian Nurses' Associ- 
ation. 

Nurses' fees, however, are,on the av- 
erage, lower than fees for other profes- 
sional or union groups, Mr. Van Raalte 
added. "For example, union dues for 
postal workers are a minimum of $5 a 
month - or $60 a year (the local unit 
can set a higher rate if it wishes). This is 
considerably higher than the association 
fee for nurses, which includes other 
benefits, such as membership fees in the 
national and international nursing asso- 
ciations and costs of the provincial 
bulletins and the national nursing 
magazine," he said. 

Mr. Van Raalte said that associafion 
fees for social workers are higher than 
those of nurses; they range from a low 
of $45 in one province to $65 in an- 
other. The yearly association fee for 
doctors in the Canadian Medical Asso- 
ciation is $300. 

Association fees for nurses registered 
to practice (renewals) in the 10 provin- 
cial associations are: 



Alberta 

British Columbia 

Manitoba 

New Brunswick 

Newfoundland 

Nova Scotia 

Ontario* 

P.E.I. 

Quebec 

Saskatchewan 



1968 1969 

$30 $35 

$37 $37 

$35 $35 

$30 $30 

$27 $35 

$25 $25 

$35 $35 

$25 $30 

$25 $25 

$27 $40 



♦Ontario nurses also pay $5 to the 
College for registration fees. 



Nurses' Associations 

Granted Salaries 

That Exceed Those Set By OHSC 

Toronto. —Through arbitration pro- 
cedures, two groups of Ontario nurses 
have been awarded salaries that exceed 
those established by the Ontario Hospital 
Services Commission. 



The Nurses' Association, Metropolitan 
General Hospital in Windsor, has been 
awarded a starting salary of $480 for 
general staff nurses, with a maximum of 
$585 to be achieved by 5 annual incre- 
ments of $21. Salaries for all other levels 
included in the contract are also above 
the OHSC stipulated figures. The Com- 
mission's declared policy for nurses' 
salaries for 1969 is based on a starting 
salary of $470 for a staff nurse, with a 
maximum salary of $570, achieved by 5 
annual increments of $20 per month. 

The Nurses' Association, St. Joseph's 
Hospital, Peterborough, received starting 
salaries of $475. 

In the Metropolitan contract, provi- 
sion is made for 3 weeks vacafion after 1 
year, 4 weeks after 5 years, and 5 weeks 
after 25 years. Teachers are to receive 4 
weeks after 1 year, and 5 weeks after 25 
years. One important provision in the 
contract was for a continuing "Pro- 
fessional Committee," made up of repre- 
sentatives of the Nurses' Association and 
the hospital. Under benefit plans, the 
hospital pays 100 percent for single 
coverage and 66-2/3 percent for family 
coverage. 

According to Isabel LeBourdais, public 
relations officer, Registered Nurses' 
Association of Ontario, "It is significant 
that, except for nurses at Riverview 
Hospital, Windsor, it is only the arbi- 
tration procedure that achieves a break- 
through from pre-determined standards 
set by a third party [OHSC]that is not 
present at negotiations." 

The Nurses' Association, Riverview 
Hospital, achieved the first collective 
bargaining contract in a hospital in On- 
tario. Under the present contract their 
starting salary moves to $500 per month, 
June 1, 1969. 

ANA Supports AMA's Move 
Against Discrimination 

New York. - The American Nurses' 
Associafion has congratulated the Amer- 
ican Medical Association on its move to 
eliminate discrimination on the basis of 
color, creed, race, religion, or ethnic 
origin. A meeting of the AM A in Miami in 
December amended the bylaws of the 
Associafion to discourage and ehminate 
discriminafion in membership. 

Dorothy A. Cornelius, president of 
ANA, had sent a message to AMA pres- 
ident Dwight L. Wilbur before the meet- 
ing, expressing an interest in the proposed 
changes, and citing the ANA's experience 
in integration. 

ANA began its fight to eliminate dis- 
criminafion in membership in 1946 by 
establishing a category of individual 
membership, allowing Negro nurses in 
states where the nurses' associations 
practiced discrimination, to join ANA 
directly. Discrimination in state and local 
districts disappeared by 1964. D 

MARCH 1%S 



names 




Loral Graham, 

who joined the staff 

of THE CANADIAN 

NURSE as editorial 
assistant in Septem- 
ber 1967, and later 
was promoted to as- 
sistant editor, resign- 
ed last month. Mrs. 
A Graham and her 
husband, who is employed by the federal 
government's Department of External 
Affairs, expect to leave Canada shortly 
for a posting abroad. Accompanying 
them will be a new member of their 
family. 

Mrs. Graham was graduated from 
Carleton University with an honors 
degree in English in 1966. She was 
employed by the National Research 
Council as an information services officer 
'before joining the editorial staff of 

THE CANADIAN NURSE. 

During her one and one-half years with 
'the journal, Mrs. Graham was responsible 



for all of the magazine's departments 
with the exception of the "News" sec- 
tion. She wrote several lively articles, one 
of which ("Defend Yourself, August 
1968) received nation-wide pubHcity. 
This same article had the distinction of 
being the first article from the 
CANADIAN NURSE to appear, in con- 
densed form, in the New York Times. 

Carol Kotlarsky 

became editorial as- 
assistant for the 

CANADIAN NURSE 

in February 1969. A 
1967 journalism 
graduate from Carle- 
ton University, Ot- 
tawa, Miss Kotlarsky 
comes to Ottawa 
from Quebec City where she was em- 
ployed as an editor by the federal Depart- 
ment of Forestry and Rural 
Development. 

While a student at Carieton University, 



Miss Kotlarsky published articles in 
School Progress, did contract writing for 
the Canadian Government Travel Bureau, 
and worked part-time for the Financial 
Times of Canada. 





Ottawa.-Governor General Roland Michener is seen presenting the Order of the 
British Empire (military division) for gallantry to Captain (N/S) Joan Cashin, 27, a 
night nurse with the Royal Canadian Army Medical Corps. The investiture took 
place in a ceremony January 4 at Government House. Nursing Sister Cashin 
received the OBE for her bravery in giving medical assistance at the crash scene of a 
( zechoslovakian aircraft near Gander International Airport September 5, 1967. 
Now stationed at Canadian Forces Base Trenton, Nursing Sister Cashin is credited 
with saving many lives. 



lARCH 1%9 



University of Toronto has granted the 
degree of Doctor of Philosophy to 
losephine Flaherty (B.Sc.N., B.A., M.A., 
U. Toronto). Dr. Flaherty earned the 
degree through the Ontario Institute for 
Studies in Education and is the first 
graduate of the University of Toronto 
School of Nursing to obtain a doctorate. 

After graduating from the school of 
nursing, University of Toronto, in 1956, 
Dr. Flaherty was charge nurse at the Red 
Cross Outpost Hospital, Matachewan, On- 
tario. From 1960 to 1962 she taught at 
Nightingale School of Nursing, Toronto, 
while working for her B.A. in history. 
After lecturing at the University of To- 
ronto School of Nursing for two years, 
Dr. Flaherty took the M.A. degree in the 
University's School of Graduate Studies, 
at the same time acting as part-time re- 
search assistant. 

At the Ontario Institute for Studies in 
Education, Dr. Flaherty is an assistant 
professor in the Department of Adult 
Education, where she teaches courses in 
psychology and adulthood, and in re- 
search and statistics. She is involved in 
research in adult education and in edu- 
cation for nursing and the professions. In 
addition. Dr. Flaherty serves as a con- 
sultant in nursing in the field of evalu- 
ation and program planning. 

Marie Therese Sa- 
bourin (R.N., St. 
Paul's H., Vancou- 
ver; B.ScN., Seattle 
U., Wash.; M.N., U. 
Washington) is the 
new director of nurs- 
ing service for the 
Registered Nurses' 
Association of 
British Columbia. She was formerly 
director of nursing service at St. Paul's 
Hospital, Vancouver. 

Miss Sabourin was bom in Ottawa and 
received her early education and teacher's 
training there. After receiving her teach- 
ing certificate in 1945, she taught in Ot- 
tawa elementary schools for five years. 

She has served on the nursing staff at 
hospitals in Saskatchewan, Alberta, and 
British Columbia and has been as active 
member of professional nursing asso- 
ciation activities. Q 

THE CANADIAN NURSE 17 




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March - May, 1969 

Continuing education courses for 
nurses, The University of British Colum- 
bia. March 20-21: The nnoternity cycle 
viewed as a developmental crisis. 
May 1-2: Preoperative nursing care. 
AAay 8-9: Nursing assessment. May 
15-16: Nursing the adult with long- 
term illness — sociological aspects. 
For information write to: Continuing 
Education in the Health Sciences, Task 
Force Building, The University of Brit- 
ish Columbia, Vancouver 8, British 
Columbia. 



March 20-21, 1969 

Workshop on hearing, measurement, 
and conservation, University of Toron- 
to. Intensive training for occupational 
health nurses, industrial audiometric 
technicians, and safety supervisors. 
Apply to: Special Programmes, Divi- 
sion of Extension, University of Toron- 
to, 84 Queen's Park, Toronto 5. 



March 20-23, 1969 
April 14-17, 1969 

Regional conferences on the use of 
audiovisual aids in nursing, sponsored 
by the Registered Nurses' Association 
of Ontario. To be held in Ottawa in 
AAarch, and Fort William in April. Fee: 
RNAO members, $25; non-members, 
$35. Write to RNAO, 33 Price St., 
Toronto 5. 



March 24-29, 1%9 

Symposium on recovery room and in- 
tensive core nursing, Grace General 
Hospital, Winnipeg. Registration: $20. 
For further details: Miss J.W. Robert- 
son, Director - Inservice Education, 
Grace General Hospital, 300 Booth 
Dr., Winnipeg 12. 




April 7, 1969 

World Health Day 
Theme: Health, Labor, 
and Productivity. 



April 13-17, 1%9 

American Association of Neurosurgi- 
cal Nurses Meeting, Cleveland, Ohio. 
Information may be obtained from: 
Miss S.M. Sowchyn, 99 Fidier Ave., 
St. James 12, Manitoba. 
20 THE CANADIAN NURSE 



April 14 - May 9, 1%9 
May 12 - June 6, 1969 

Rehabilitation Nursing Workshops, 
University of Toronto. Four-week 
course for R.N.s employed in acute 
general end chronic illness hospitals, 
nursing homes, public health agencies, 
and schools of nursing. Tuition fee: 
$150. Apply to: Division of University 
Extension, Business and Professional 
Courses, 84 Queen's Park, Toronto 5. 

April 20, 1969 

Second Annual Dialysis Symposium 
for Nurses, held in conjunction with 
annual meeting of American Society 
for Artificial Internal Organs, at Chal- 
fonte-Haddon Hall, Atlantic City, New 
Jersey. Organized by the US Public 
Health Service's Kidney Disease Con- 
trol Program. For further information 
write: Michael A. Byrnes, Information 
Services Section, Dept. of Health, Edu- 
cation, and Welfare, Public Health 
Service, Health Services and AAental 
Health Administration, 4040 North 
Fairfax Dr., Arlington, Virginia 22203. 

April 28 - May 2, 1%9 

Final workshop of the Extension 
Course in Nursing Unit Administra- 
tion, Regina, offered in English and 
French to registered nurses in adminis- 
trative positions who are unable to 
attend university. Sponsored by the 
Canadian Nurses' Association and the 
Canadian Hospital Association. For 
further details and application forms 
for the 1969-70 class, write to: Direc- 
tor, Extension Course in Nursing Unit 
Administration, 25 Imperial Street, 
Toronto 7. 

May 5-7, 1%9 

Workshop for teachers on test cons- 
truction, conducted by Professor V. 
Wood, School of Nursing, The Univer- 
sity of Western Ontario. Theme: Task- 
oriented work sessions on essay ques- 
tions, models for marking essay ques- 
tions; objective examinations and 
item-writing practice sessions; and 
final assessment of student nurses. 
Send applications to: Mi^s Angela Ar- 
mitt. Summer School and Extension 
Department, The University of West- 
ern Ontario, London, Ont. 

May 12, 1969 

Alumnae Association of the Toronto 
General Hospital School of Nursing, 
75th anniversary. Events for the week 
of May 12 include tours of the new 



school and residence, graduation exer- 
cises, and dinner at the Royal York 
Hotel. For dinner tickets ($8.50) and 
further information write: Mrs. Grieg 
Brown, 27 Thorncliffe Park Drive, Apt. 
301, Toronto 17. 

May 13-16, 1%9 

Alberta Association of Registered 
Nurses, annual convention, Mocdo- 
nald Hotel, Edmonton, Alberta. 

June 16-18, 1%9 

Conference on nursing education for 
visitors to the International Council of 
Nurses Quadrennial Congress. Spon- 
sored by the school of nursing and 
alumni association. University of To- 
ronto. June 19-20: tours in Toronto 
and environs to be arranged at re- 
quest of persons attending conference. 
Apply to the Secretary of the School, 
University of Toronto School of Nurs- 
ing, 50 St. George St., Toronto 5. 



June 22-28, 1969 



auAMiMui 




International Coun- 
cil of Nurses' Qua- 
drennial Congress, 
Montreal. Fee: be- 
fore AAar. 31, $40; 
after Mar. 31, $60. 
Write to: ICN Con- 
gress Registration, 
50 The Driveway, 
Ottawa 4, Ont. D 




PROFESSIONAL NURSING 
PERSONNEL 

Personnel Office for Registered Nurses 
HOSPITAL NURSING 
INDUSTRIAL NURSING 
PUBLIC HEALTH NURSING 

50 Place Cremazie, suite 1406 

Montreal, Quebec 

Area Code (514) 388-4427 



MARCH 1%S 



COMING EARLY in 1969 

BEDSIDE NURSING TECHNIQUES IN MEDICINE AND SURGERY 2nd Ed. 

By Audrey Latshaw Sutton, R.N., formerly Director of Nursing Service, Edgewood Hospitol, Berlin, N.J. 
and Instructor, Wilmington (Del.) General Hospital 

Used by more than 80,000 nurses, this source book of advanced clinical nurs- 
ing techniques has now been nnade even nnore valuable in the new Second 
Edition. In clear, precise language supplennented by more than 750 explicit 
drawings, Mrs. Sutton tells precisely how to perform hundreds of nursing func- 
tions, from intramuscular injection to caring for the patient in hyperbaric oxygen 
therapy. In the first part of the book she describes the basic techniques that are 
common to all areas of clinical nursing; then she takes up specialized techniques 
used in disorders of each of the body systems. Nurses by the tens of thousands 
have found this book unparalleled as an advanced text, as a "refresher," and 
OS a reference at the nursing station. It is even more valuable in the new Second 

Edition. About 460 pages, with over 750 illustrations. About $9.20. Ready March. 

NURSING OF CHILDREN: A Guide for Study 

By Debro Hymovich, R.N., B.S., M.A., University of Florida 

This new study guide and workbook in pediatric nursing does more than just 
present facts and techniques. It uses a realistic case study approach that calls 
for the creative integration of knowledge — just as actual nursing practice does. 
In this book you read about a case as you would encounter it on the pediatric 
service. You are asked to answer questions that review your knowledge of 
anatomy, physiology, and pharmacology. You are asked to make plans for 
nursing care and to interpret the results of tests, and you plan the instructions 
and explanations and would give the patient's family. Nineteen specific condi- 
tions ore discussed; among them they encompass almost the entire range of 

pediatric nursing. About 2S0 poges, illustrated. About $4.90. Ready March. 

FUNDAMENTAL SKILLS IN THE NURSE-PATIENT RELATIONSHIP 

By Lianne S. Mercer, R.N., B.S.N., M.S., formerly of the University of Michigan, and Patricia O'Connor, 
Ph.D., University of Michigan. 

A nurse educator and a psychologist have jointly developed a teaching program 
for the vitally important but often neglected skills of interpersonal relations. This 
seven-hour instructional unit thoroughly covers such topics as "Utilizing 
Resources in Patient Care," "Structuring the Professional Relationship," and 
"Communication Skills." It answers such questions as: What should you say 
if a patient refuses a treatment? How should you respond when a patient asks 
about his diagnosis or prognosis? How can you get more information from 
written records and from the patient himself when you need it? The principles 
upon which effective nurse-patient relationships are based become clear as 

you proceed through the program. About 150 pages. About $3.80. Ready AAorch. 

GROWTH AND DEVELOPMENT OF THE YOUNG CHILD 8th Ed. 

By the late Marion Breckenridge, M.S., formerly of the Merrill-Palmer Institute, and Margaret Nesbitt 
Murphy, Ph.D., Purdue University. 

Now in new Eighth Edition, this text unfolds the physical, mental, emotional, 
and spiritual development of the preschool child. It explains current concepts 
of growth, development, and maturation and traces the interactions between 
them. This book will enrich the understanding of anyone who works with 

children. About 500 pages, illustrated. About $9.75. Just Ready. 

W. B. SAUNDERS COMPANY Canada Ltd., 1835 Yonge Street, Toronto 7 

Please send on approval and bill me: 

Author: Book title: 




Zonei „ Province: 

CN 349 



MARCH 1%9 THE CANADIAN NURSE 21 



in a capsule 



Don't call me: I'll call you 

A doctor in Manitoba tells this amu- 
sing anecdote: 

"Following a cerebrovascular ac- 
cident, 1 spent several months in the 
rehabilitation ward of a large hospital. I 
then was discharged to complete the 
adjustment in my home. Arrangements 
were made for the rehabihtation depart- 
ment to loan me an ordinary metal urinal, 
familiarly known as the 'bottle.' 

"Following delivery of the 'bottle,' I 
received a surprising letter. It stated: 

You are responsible for maintaining the 
loaned equipment in good condition. Our tech- 
nician will call at your home in the near future 
to show you how to use it. 

"Although the letter came some time 
ago, the technician has not yet called. 1 
have just had to make use of the equip- 
ment as best I could without the benefit 
of his specialized knowledge." 



Nursing can turn you on 

Soul music and space suits are not 
generally used to attract young people 
into nursing. But a high school in Roches- 
ter, New York, was the scene, and the 
American Nurses' Association, in league 
with Ex-Lax Inc., was the sponsor of just 
such a happening. 



The happening was called a "Soul 
Seminar" and was aimed at underprivi- 
leged junior high school students. Fifteen 
hundred students, mainly Negroes, at- 
tended. 

"The Fantastic Entertainers," a Roch- 
ester musical group, provided a "soul" 
background, while the nurse of 2001 ~ a 
moon-nurse - modeled her uniform, 
complete with space boots and moon- 
beam. A copy of a new pamphlet, "Nurs- 
ing Can Turn You On" was given to every 
student, and a Rochester nurse narrated 
an original slide and "live" presentation 
of "Nursing - Past, Present, and Future," 
which emphasized the history and contri- 
butions of black women to nursing. A 
Negro nurse educator gave a first-person 
account of "Why 1 Became a Nurse," and 
the students joined in a question and 
answer period. 

The ANA is deeply involved in matters 
of human rights and has taken a public 
stand on civil rights. The Association is 
concerned about the low percentage of 
Negro students entering nursing: although 
1 1 percent of the U.S. population is 
black, only 3 percent of nursing students 
are Negro. The Rochester soul seminar 
was only the beginning of an accelerated 
drive by the ANA to make American 
nurses more truly representative of all 
Americans. 




Want International friends? 
You 're sure to find them at the ICN Congress in Montreal this June. 



21 THE CANADIAN NURSE 



A bacchanalian tale 

Throughout history, wine has been 
used as a tranquilizer. Modem doctors 
have added to the therapeutic uses of 
wine. They have prescribed wine for 
anemic patients, since wine is rich in iron; 
for diabetics, since dry wine is a no-sugar 
energy source that requires no insulin; for 
cardiovascular diseases, since it lowers 
blood cholesterol and is relaxing; for 
infectious diseases, since wine pigments 
have antibacterial action; and for kidney 
diseases, as wine is an effective diuretic. 

In the January-February issue of 
Modem Nursing Home, two Chicago 
doctors strongly recommend that wine be 
served in hospitals along with the evening 
meal. Dr. Vincent Sarley, medical direc- 
tor of Wrightwood Extended Care Facili- 
ty, and Dr. Robert C. Stepto of the 
College of Medicine, University of llli- , 
nois, have closely compared the attitudes j 
of patients who drank wine with dinner " 
with those of patients on a "dry" diet. It 
appears that wine-imbibing patients not 
only sleep better than their teetotalUng 
fellows, but they also become supremely 
satisfied with life in a hospital bed. 

• 90 percent of wine-consuming patients 
were happy with visiting hours and regu- 
lations, whereas only 43 percent of non- 
wine patients were. 

• 100 percent of wine-drinking patients 
found their beds comfortable, compared 
with only 57 percent of non-wine pa- 
tients. 

• 85 percent of wine-drinking patients 
were happy with their food, whereas only 
43 percent of non-wine patients were. 

• 43 percent of wine-drinking patients 
liked their doctors, compared with only 
1 8 percent of non-wine patients. 

• 83 percent of non-wine patients com- 
plained of being awakened too early in 
the mornings, although only 40 percent 
of the wine-drinkers did. 

• 78 percent of wine-drinking patients 
found their rooms quiet enough, in com- 
parison with only 57 percent of non-wine 
patients. 

Lest you have visions of beaming 
"wine patients" cheerily gobbling their 
food between healthy swills from a large 
green bottle and giving their nurse an 
affable pinch and their doctor a rosy- 
nosed smile before passing out for the 
night with a final hiccup, Drs. Sarley and 
Stepto report that the patients under 
study were served only two ounces of 
wine with dinner. 

Now that's what we call the power of 
suggestion! □ 

MARCH 1%9 



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WHTTFV^ f*^"^"^ Oxfords. Here's a beautiful way to 

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Remember the Foot Health Seminar - Hospital for Sick Children, Monday, June 2nd. 



OPINION 



Thought and action 

This biennium, nurses must make a serious decision about the future role of 
their national association. Nurses have directed the Canadian Nurses' Association 
to enlarge its services — but at the same time they have decided to hold the 
line on the budget. Some of the implications of this paradox are examined 
in this article. 



The financial status of the Canadian 
Nurses' Association has become so tight 
that even the cost of stamps threatens to 
put the Association into the red. 

Unfortunately, the cost of stamps is 
not, for the CNA, a minor matter. In fact, 
the postal rate increases that go into 
effect April 1 will cause something of a 
financial crisis. 

At the next general meeting of the 
CNA, nurses must make some serious 
financial decisions. These need to be 
considered carefully, because they will 
influence the future of nursing in Canada 
for some time to come. 

At the last general meeting, the deci- 
sion on finances was — for all practical 
purposes — postponed. A special ad hoc 
committee was appointed to investigate 
all implications and alternatives of na- 
tional and provincial responsibilities, in- 
cluding fees. It will report back to the 
general meeting in Fredericton in June 
1970. 

In the meantime, the CNA was asked 
to tighten its belt, and to manage the 
estimated 1 3 percent increases in costs on 
the same budget as for the 1966-68 
biennium. This, the CNA might have been 
able to do, if it had not been faced with 
the postal increases. 

Postal rates are up. The cost to the 
CNA for mailing journals will be about 1 5 
times as much as it was before. These 
costs will not wait until the next 
biennium. They start next month. The 
increased postal rates passed by the 
House of Commons excluded the Ca- 
nadian NURSE and L'infirmiere cana- 
dienne from the privileged postal rates 
they have enjoyed in the past. The 
MARCH 1969 



Ernest Van Raalte 

journal mailing costs will rise by about 15 
cents per copy or SI. 80 a year per 
member. This is effective April 1, 1969. 

As well, the CNA has had to go 
forward with programs already com- 
mitted, such as the National Testing 
Service and the International Council of 
Nurses' meeting. 

The special ad hoc committee and the 
Board of Directors will debate wisely and 
report fully. The decision, however, rests, 
as it always does, with you - the indivi- 
dual nurse. 

1966-68 — Years of Expansion 

At the 33rd General Meeting of the 
Association in Montreal in July, 1966, 
the members endorsed a program of 
increased activities for the national 
association. They approved an increase in 
membership fees from S6 to $ 1 to meet 
these activities. This meant many changes 
and an expanded role for CNA. 

For the first time, the Association was 
able to hold meetings of provincial per- 
manent staff in counterpart groups. The 
10 provincial members on social and 
economic welfare, pubHc relations, nurs- 
ing service, and nursing education were 
able to come together to identify 
common problems and work together 
toward their solution. 

An advisory service to provincial as- 
sociations was begun. CNA consultants 
went from coast to coast to conduct 
collective bargaining workshops and con- 
ferences (19 in that biennium), nursing 
service workshops (9), Ubrary workshops 

Mr. Van Raalte is General Manager of the 
Canadian Nurses' Association, Ottawa. 



(3), and a workshop for nursing faculty 
(1). All provincial associations used the 
services of CNA consultants in these areas 
and as well turned to CNA for help in 
research and statistics and in organization 
and management. 

The important work of communi- 
cating information about nursing and its 
behefs was expanded. Improvements in 
THE CANADIAN NURSE and L'infir- 
miere canadienne were effected, and eight 
new books and pamphlets were produced. 
These included Hie Leaf and the Lamp — 
a history of CNA; Countdown 1967 - 
the first book on Canadian nursing statis- 
tics; PR Pointers - a practical guideline 
for communications between nursing and 
other groups; and CNA: What It Is, What 
It Does — a pamphlet addressed to senior 
government officials, allied organizations, 
the press, and others in positions of 
influence. 

CNA also increased its participation in 
the work of other organizations, for this 
gave it the long-desired opportunity to 
interpret beliefs and policies about nurs- 
ing to other agencies. Relationships were 
extended with groups such as the Can- 
adian Medical Association, the Canadian 
Hospital Association, the Canadian Public 
Health Association, the Canadian Council 
on Hospital Accreditation, and the De- 
partment of National Health and Welfare. 
A clearer understanding of nursing's goals 
and pohcies was achieved through the 
active participation of CNA representa- 
tives at the many conferences and com- 
mittee meetings with these agencies. 

All these expanded activities were 
designed to improve the status and con- 
dition of Canadian nursing and to 
THE CANADIAN NURSE 25 



strengthen the position of the profession. 
The results obtained since this program 
went into effect in 1966 are remarkable. 

1968-70 — Hold the Line 

At the general meeting in Saskatoon in 
July 1968, the Board of Directors report- 
ed proudly on the activities of the 
1966-68 biennium. They advised that 
the $10 fee per member would accommo- 
date rising costs and that the Associa- 
tion's activities could be maintained at 
the same effective level. 

However, a motion was passed that 
for the 1968-70 biennium only, in 
member (provincial) associations whose 
membership exceeds 20,000, the fuU 
annual fee per member be S6.00 and m 
member associations whose membership 
is 20,000 or less the full annual fee per 
member be $10.00 and that the Board of 
Directors be empowered to adjust the 
budget accordingly." 

This had the effect of reducing the 
income-per-member from $10.00 to 
$8.67. The Board of Directors faced a 
dilemma: to reduce expenditures by over 
13 percent while costs were increasing in 
similar proportion, and to do so without 
damaging the effectiveness of the pro- 
grams. 

On another motion from the general 
meeting, the Board of Directors 
appointed a committee to study the 
question of membership and fee structure 
and make recommendations to the pro- 
vincial associations six months prior to 
the 1970 general meeting. This com- 
mittee will examine, too, the national and 
provincial associations' functions and re- 
lationships and the incorporation docu- 
ments and bylaws of CN A. 

At present, all members of provincial 
associations are members of the Canadian 
Nurses' Association and the International 
Council of Nurses. The fee for member- 
ship in both these organizations is a part 
of the annual fee that the provincial 
association pays to CNA on behalf of the 
member. 

Prior to the Motion reducing the 
annual fee for members in provincial 
associations with over 20,000 members to 
$6.00 for this biennium, all individuals 
contributed equally to the financing of 
CNA and ICN. 

Balancing the budget 

Based on a $10 per individual nurse 
fee, the proposed 1968-70 budget look- 
ed something like this: 
ICN Individual member fee .40 

Net cost of journals $ 3.00 

Board and committee meetings $ 1 .94 
Research and advisory services $ 1.72 
Sponsorship $ 1.41 

Library and archives .92 

Public Relations .61 

$10.00 

With less money coming in, the Board 

of Directors has to consider which of 

these services can be cut. Certain of the 

26 THE CANADIAN NURSE 



costs - such as the ICN fee, costs of 
holding statutory meetings, and building 
costs - are fixed. 

Even before the Board's first major 
meeting of this biennium, the task was 
further compUcated by the increase in 
postal costs. 

The Board of Directors and the Ad 
Hoc Committee on Functions, Relation- 
ships, and Fee Structure will look at each 
area and propose how the Association 
will meet its obligations during the next 
year. They wiU closely examine the fol- 
lowing areas: 

ICN individual fee 

The ICN is a federation of 63 nafional 
nursing associations. Your membership 
fee and similar fees from the individual 
members of all the member national 
associations around the world finance 
the ICN. Canadian nurses, as hosts of 
the ICN Congress in Montreal this 
summer, can hardly withdraw 
membership at this time. 
Net costs of journals 

Each member of the CNA receives 
monthly issues of the journal in the 
language of her choice. The $3.00 
budget allocation represents the net 
cost per member after advertising 
revenue. It covers the salary and travel 
expenses of the editorial staffs, and 
the costs of postage, printing, trans- 
lation, design, art, photography, and 
all other costs connected with journal 
pubUcation and circulation. The new 
postal rates will raise costs by $1.80. 
Changes in quality, size, or frequency 
of pubUcation could considerably 
reduce advertising revenue. 
Board and committee meetings 

This covers the travel costs and all 
other expenses connected with con- 
vening meetings of the Board of Direc- 
tors, the Executive Committee, the 
standing committees, and general 
meetings that are mandatory by sta- 
tute. It also covers the cost of ad hoc 
committee meetings and other non- 
statutory meetings convened for 
special purposes. 
Research and Advisory services 

The research and advisory staff plan 
and conduct all workshops and pro- 
vide the advisory services to provincial 
associations mentioned earlier. In 
addition, they compile and publish 
statistic^ data, write and publish 
technical papers, participate on inter- 
agency committees, prepare briefs to 
government commissions, plan and 
conduct provincial counterpart con- 
ferences, and act as secretaries and 
resource people to the various standing 
committees. This portion of the fee 
covers the salary and travel expenses 
of the Research and Advisory staff, 
and the cost of counterpart meetings, 
collecting and processing statistical 
data, and the printing of technical 
publications. 



Sponsorship 

This is the amount set aside to contri- 
bute to and administer such activities 
as the Canadian Nurses' Foundation, 
and CNA Student Loans and to sub- 
sidize special nursing events, such as 
the ICN Congress. 
Library and Archives 

This covers the costs of preparing 

bibUographies and providing Ubrary 

research services for all CNA studies 

and programs. As well, book loans are 

made to individual members across 

Canada, and to nursing students and 

others interested in nursing. The CNA 

Library is the only comprehensive 

collection of nursing literature in the 

nation. Its repository collection of 

nursing studies is a major resource for 

research in nursing in Canada, and the 

periodical collection of some 300 tities 

is probably one of the best in the 

world. The cost of all acquisitions, 

subscriptions, binding and supplies, as 

well as the salaries and travel expenses 

of library staff, is covered by this 

portion of the fee. 

Public Relations 

The public relations officer gathers, 
prepares, and distributes information 
about nurses and nursing activities to 
the public through press, television, 
and other media; to the provincial 
associations through constant com- 
munication with provincial counter- 
parts; and to the members through the 
news columns of the journals. She also 
plans and conducts provincial public 
relations counterpart meetings. This 
portion of the fee covers the salary 
and travel expense of the PRO, con- 
sultant fees, the cost of counterpart 
meetings, promotional publications, 
and special public relations events. 
The portions of fee allocated above for 
the various activities cover all CNA costs, 
including the cost of owning, operating, 
and maintaining the national head- 
quarters building and the salaries and 
expenses of administrative and general 
office personnel. 



Think — because you must act 

The problem is immediate, and it 
places a serious responsibility on each 
member of the Association. The Board of 
Directors and the Ad Hoc Committee will 
deliberate these problems on your behalf 
and be prepared to make recommenda- 
tions at tiie next general meeting. 

But it is up to each individual nurse to 
consider the alternatives objectively. You 
must give direction to your voting de- 
legates so that the right decisions are 
made. 

The future of nursing is in the hand; 
of the nurses. The time has come foi 
action. Action without thought oi 
thought without action can be equallj 
disastrous. C 

MARCH 1%' 



Infections in the hospital 



Modern hospitals may be as up-Jo-date as tomorrow, but they have not solved 
yesterday's problem — infection. Antibiotics alone cannot control infections; 
the first line of defense rests with diligent staff members, aided by an active 
infection control committee. 




What do you mean I look a cyte? I am a 
■te! " 



Dorothy Pequegnat 

Over 100 years ago, Joseph Lister 
published his first notes on wounds and 
abscesses and stressed the antiseptic 
treatment of wounds. His liberal use of 
phenol led to a decrease in the number of 
infections, and so began the era of anti- 
septics. This was replaced by the aseptic 
era, based largely on the teaching of 
Florence Nightingale. 

In 1929, Sir Alexander Fleming 
changed the whole outlook on microbial 
disease with the discovery of penicillin 
and thus began the antibiotic era. Anti- 
biotics would put an end to infections, it 
was thought, but as everyone must now 
recognize, this hope has not been fulfill- 
ed. 

A noticeable decrease in infections in 
hospital did follow the initiation of anti- 
biotics, and the hospital and medical staff 
became less concerned about the dread 
"spiked temperature" and the "jaws of 
death" on the temperature-pulse-respi- 
ration charts. Then, about 1 2 years ago, 
some bacteria, especially some strains of 
Staphylococcus aureus, became resistant 
to the antimicrobial drugs, causing gross 
infection and sometimes mortality. 

Early in 1958, the first of five yearly 



ARCH 1%9 



Mrs. Pequegnat has been the Infection Control 
Officer at the Ottawa Civic Hospital since the 
beginning of the present program in July 1967. 
In 1966 she participated in a preliminary 
research project, which led to the start of the 
present program. She is a graduate of the 
Ottawa Civic Hospital and has a certificate in 
public health and a diploma in microbiology 
(infection control) from the University of 
Ottawa, Canada. 



meetings was held at the National Re- 
search Council in Ottawa. The objective 
of these meetings was to provide a focal 
point for the submission of proposals 
regarding the control of Staphylococcal 
infections in hospitals. In that same year, 
a national conference on "Hospital 
Acquired Staphylococcal Disease" was 
sponsored by the United States Public 
Health Service and the National Academy 
of Sciences, and in England lectures were 
started at the Royal College of Surgeons 
on "Spread of Infections." 

This world-wide concern over cross 
infections in hospitals has led to today's 
hospital infection control committees and 
to considerable knowledge about hospital 
infections. The organism that caused this 
concern about cross infection in the 
1950's — a particularly virulent and anti- 
biotic-resistant strain of Staphylococcus 
aureus - had developed, and was flourish- 
ing in patients whose normal flora had 
been destroyed by antibiotics. Anti- 
biotics, in this instance, were not useful 
as treatment. However, this virulent strain 
has now more or less died out. 

Today, most hospitals now do routine 
antibiotic sensitivity testing on all 
cultures to help identify any infection 
with antibiotic-resistant bacteria. 

For many years it was believed that 
bacteria reproduced by simple binary 
fission and that resistance to antibiotics 
arose as a result of mutation. Recently it 
has been found that bacteria may re- 
produce by sexual conjugation and that, 
by means of a so-called resistance transfer 
factor, or R factor, resistance to one or 
more antibiotics may be transferred from 
THE CANADIAN NURSE 27 




". . . and stop referring to me as 'that •' You're righ t .. ■ J t 
foreign body. ' " pepp..p..p..a..a..a..a..a...CHOO.' 



IS 



one strain or species of bacteria to an- 
other. Because of this, a relatively 
harmless organism can pick up the R 
factor causing infection or transfer its R 
factor to a more virulent organism which 
could cause gross infection. 

Many new antibiotics are being 
produced for use in hospitals today, but 
it is important that antibiotics be recog- 
nized as a second line of defense and that 
hospital staff understand and strive to 
block the many other channels where 
infection can spread. 

Endogenous or hospital spread? 

Almost half the infections seen in 
hospital are in patients admitted with 
their infection. Those noted after the 
patient has been admitted are called 
"hospital acquired" infections. Infections 
may also occur after the patient goes 
home; these the hospital may never hear 
about. 

Many so-called "hospital-acquired" in- 
fections really occur by endogenous 
spread or are affected by one of many 
variables; it can be difficult to say just 
which are caused by cross infection. It is 
important not to divorce the infection 
from the circumstances surrounding it, 
just as it is important that the hospital 
examine procedures to prevent cross con- 
tamination and cross infection. 

Nurses and other personnel sometimes 
fear infection; this can cause danger to 
the patient both mentally and physically, 
if it leads to an ostrich attitude and 
neglect in nursing care. Much of this fear 
is founded on inadequate understanding 
of how infections are transmitted and on 
28 THE CANADIAN NURSE 



a failure to realize the safeguards offered 
by good technique. 

For example, gas gangrene is a very 
serious condition for the patient and one 
we hope never to see. However, incidence 
of cross infection between patient and 
ward personnel is almost unknown. The 
organism Gostridium perfrigens, which 
causes gas gangrene, is around us most of 
the time, and some 20 to 30 percent of 
the population are carriers, but the organ- 
ism needs special conditions to produce 
toxins. General cleanliness and the use of 
steam sterilization rather than boiling or 
cold sterilization lessen the chance of the 
spore getting into deep tissue, as it once 

did. 

Even those hospitals with good in- 
fection control programs will always have 
problems with infections - especially 
those admitted from the community. 
Also, because of the use of immuno- 
suppressive drugs, steroid therapy, long 
surgical procedures, and increasing num- 
bers of patients with traumatic injuries 
and terminal disease, hospitals are dealing 
with many more high risk patients who 
are susceptible to infection. Hospitals 
therefore must consider even more pre- 
cautions. 

In general, a large inoculum or gross 
contamination will lead to cross in- 
fection. Each department must carefully 
examine its own area and set up rigid 
standards for cleanliness, whether for the 
incubator in the nursery, the whiripool 
bath in physiotherapy, the dialysis 
machine in urology, the ECG equipment 
in the intensive care unit, or the general 
housekeeping all through the hospital. 



Personnel must also realize that to give 
good nursing care it means coming in 
close contact with patients. Good nursing 
techniques help prevent cross infection, 
but of all these good hand-washing is 
most important. 

Infection control also includes a well- 
planned training program in which 
personnel can consider the why behind an 
infection as well as what should be done 
about it. 

Modern units make it easier 

Many of the changes in today's hospi- 
tals make infection control easier. Auto- 
claves, gas sterilizers, disposable equip- 
ment, new bacteria-resistant fabrics foi 
blankets or staff clothing, or specially 
filtered air conditioning are examples 
New agents for cleaning, skin scrubs, anc 
germicides are being tested as well. 

All of this is to no avail, however 
unless it is property used in the end. / 
dirty mop in housekeeping will offset thi 
effect of a good cleaning agent. A single 
use, disposable item repeatedly used n( 
longer carries the benefits it was designei 
for - and may even serve as a carrier fo 
infection. A closed drainage system wit' 
a hole cut into it is no longer close^ 
drainage. "Sterile" packages crushed an 
man-handled into a drawer may no longe 
be sterile. 

Even a hospital designed to the bet 
advantage for control of infections is t 
no avail unless the principle behind th 
design is understood and carried out. 

Staff have done many things in th- 
same ways for so long that they may fir 
it hard to change, but the hospital 

MARCH 19i^ 



changing, the type of surgery is changing, 
and equipment is changing. There are 
many areas where the habits of the 
personnel must change, too. Hair may 
provide a reservoir for bacteria - which 
means complete hair covering may be 
needed in some areas besides the oper- 
ating room. Constant movement stirs up 
bacteria-laden dust particles - which 
means that flow of traffic should be 
controlled, especially in high risk areas. 
Patients adnitted to the hospital with an 
infection can unwittingly serve as carriers 
to other patients - which means that 
they need to be told of their potential 
danger to others. Uniforms and clothing 
worn outside the hospital increase the 
probability of bringing in infection — 
which means staff, especially those with 
the high risk patient, should change at the 
lospital. 

Medical as well as nursing staff and 
Dther personnel must realize that they 
;ach play a role in microbial dissemi- 
lation. 

Constant surveillance needed 

At the Ottawa Civic Hospital, an In- 
fection Committee meets every month to 
discuss infections occurring during the 
nonth, problems that may be arising, or 
my changes to be made. Day-to-day 
urveillance is done by the medical bacte- 
iologist, the director of health service, 
ind an infection control officer. 

Surveillance consists of case finding 
md hospital monitoring. Case finding 
neans actually looking for any possible 
nfections in the hospital by having the 
)acteriology department report all in- 
ections to the infection control officer, 
becking the elective and emergency 
urgery list, and checking the diagnoses of 
latients admitted to the hospital. Even 
aore important are the routine visits to 
he head of each department. Cooper- 
tion, including reports about infections, 
; thus ensured. 

Screening procedures for infection are 
ilso carried out for staff. Through the 
ersonnel Health Service, stool cultures 
re done routinely on all food handlers to 
heck for the possible chance of a carrier, 
lantoux testing is done on all negative 
iberculosis reactors and chest x-rays are 
one once a year on all staff. All staff are 
ncouraged to report infections to health 
:rvice. 

This way it is possible to have an 
verall picture of the types of infection in 
4ARCH 1%9 



the hospital at any given time. 

Hospital monitoring means doing 
bacteriological surveys of different hospi- 
tal departments, such as kitchen and 
operating rooms. There are two types of 
monitoring, one is routine sampling and 
the other involves a series of samples 
from a specific area to search for the 
solution to a specific problem. 

Bacteriological sampling can indicate 
constant trouble spots, such as hard to 
clean areas, and can demonstrate the 
efficiency of the present methods of 
cleaning. When evaluating cleaning 
measures, it is important to realize that 
many extraneous factors may effect the 
result. Environmental sampling cannot be 
related directly to infections except in 
rare and atypical cases. However, it can 
be used to improve operational practices 
and to attain the lowest contamination 
level possible. 

To isolate or not 

Infections may be epidemic or en- 
demic. Some infections, such as in- 
fectious diarrhoea, or any communicable 
disease, such as measles, should call for 
immediate action and isolation for the 
patient. The hospital population would 
be watched for other cases to develop, as 
this might signal the start of an epidemic. 

Other infections, such as wound in- 
fections, are watched over a period of 
time to see if there is any indication of an 
endemic pattern. If the same organism 
keeps reappearing in a certain area, im- 
mediate action is needed to try and find 
its source and to clear up or remove the 
reservoir. 

Isolation procedures need not be rigid, 
all-or-nothing routines. Many different 
organisms cause infections, and, as well, 
different grades of infection occur. It 
would seem best to grade the isolation 
procedure also, and correlate it with the 
infection. 

Complete isolation would be used for 
the patient with, for example, a com- 
municable disease, infectious diarrhoea, 
or grossly contaminated burns. This 
would mean that everything going into 
that room would need to be decon- 
taminated before being brought back into 
general use. 

Separation would be used for the 
patient with, for example, an infected 
wound. Care could be given in the general 
ward or in a single room if one is 
available. Everything coming in contact 



with the wound would be contaminated. 
This procedure requires complete under- 
standing by the personnel caring for the 
patient as well as by the patient himself. 

Reverse isolation would be used for 
highly susceptible patients, such as the 
recipient of an organ transplant, the 
uninfected burn patient, or a patient with 
a low blood count. 

The need for isolation also depends on 
chemotherapy. The patient with a group 
A beta hemolytic streptococci infection 
responds rapidly to treatment with 
pencillin and the chance of cross in- 
fection is lessened. The tuberculosis 
patient responds to treatment with Iso- 
niazid, which again lessens the chance of 
cross infection. 

Conclusion 

Increased awareness of the problem of 
infection in hospitals, more knowledge 
about how infections are caught and how 
they are spread, wise application of the 
advances in hospital technology, constant 
surveillance, and adequate treatment for 
infections are the goals of infection con- 
trol. 

The hospital is a complex community 
requiring the help of many people to 
keep it functioning. Infection control 
committees can help, but infection con- 
trol really depends on the cooperation of 
each individual. 

Bibliography 

Green, V.W. Recent advances in the control of 
hospital infections./ Hasp. Res. Vol.6, Jul. 
1968, p.25. 

Kabins, S.A. and Cohen, S. Resistance-transfer 
factor in enterobacteriaceae. New Eng. J. 
Med Vol. 275, Aug. 4, 1966, p.248-252. 

Noble, W.C. Staphylococcus aureus on the hair. 
/. Clin. Path. Vol 19, Nov. 1966, 
p.570-572. 

Schaeffer, R.L. Practical aspects of surface 
sampling. Hospitals, Vol. 42, April 16, 
1968, p.94-100. 

Starkey, H. Control of staphylococcal in- 
fections in hospitals. Canad. Med. Ass. J. 
Vol. 75, Sep. 1, 1956, p. 37 1-380. 

Williams, R.E.O. et al. Hospital Infection: 
Causes and Prevention. London, Lloyd- 
Luke, 1966. D 



THE CANADIAN NURSE 



29 



idea 
exchange 



A "Two-Way" Street 
Over the past years, there has been a great 
deal written and said about the 
contributions which the hospital pharma- 
cists can make to nursing education and 
nursing service. This is true, particularly 
in the area of pharmacology, which 
would cover such topics as therapeutic 
agents, adverse drug reactions, metrology, 
and preparation and administration of 
drugs - but what of the contributions 
nurses can provide to hospital pharma- 
cists? 

At St. Michael's Hospital in Toronto, 
the Department of Pharmaceutical Ser- 
vices holds weekly staff conferences and 
it was such a meeting that gave birth to 
the idea of nurses lecturing to pharma- 
cists. The pharmacists themselves recog- 



nized their lack of knowledge in so many 
areas which go to make up a nurse's 
"day." 

If pharmacists are to play an active 
part in the team, then an intelligent 
approach is to recognize that they may 
not know the situation as it exists "up on 
the nursing units." 

Some hospitals have begun programs 
of "clinical pharmacy," which will be the 
answer to many problems, however even 
before the pharmacists can function in a 
clinical pharmacy setting, they should 
have a basic knowledge of nursing pro- 
cedures, policies, and work-load. 

At St. Michael's Hospital, when the 
director of nursing service had given 
approval to the tentative plan, the nurse- 
coordinator of special projects, Dorothy 



Shamess, went to work with the pharma- 
cists and head nurses to set up the 
educational program. Miss Shamess met 
with pharmacists and discussed the areas 
in which they were interested. These were 
used as a basis for the program. 

Even recent graduates from schools of 
pharmacy have very limited knowledge 
and experience in actual nursing pro- 
cedures; the same holds true for those 
pharmacists who, after spending some 
time in the community pharmacy, have 
entered the field of hospital pharmacy. 
There is a trend, however, to include 
clinical pharmacy in the medical science 
complex of universities, and the day may 
not be too distant when pharmacy stu- 
dents will join with medical and nursing 
students in the hospital wards for a more 




Sister St. Matthew, supervisor and instructor of the Urology Unit, assisted by Miss Mulcahy, head nurse, explains to the pharmacy 
staff principles of irrigation and dialysis. 

30 THE CANADIAN NURSE MARCH 1969 



neaningful course in clinical work. 

CJioice of subjects 

At St. Michael's, the following topics 
.vere chosen as material to be included in 
he inservice course for the pharmacists: 
;olostomies. bladder irrigation and ca- 
heterization, peritoneal dyalysis, treat- 
nent. including corrpresses, of bed sores 
ind ulcers, tube feedings, and charting. 

Lectures were given weekly, on 
Puesdays and Thursdays - each lecture 
leing repeated so that all pharmacy staff 
:ould attend. Initially the lectures were 
'0 minutes in length, but as the program 
ieveloped the lectures were extended to 
ine hour. 

Miss Shamess organized all the lectures 
.nd demonstrations and the pharmacy 



department was notified of the ar- 
rangements on a weekly basis. The form 
of the presentation varied with the topic 
but in general it was a lecture, which 
covered anatomy, physiology, etiology, 
and treatment, followed by a demon- 
stration at the bedside of the patient. At 
the lecture on dialysis a film was shown, 
giving a further explanation of peritoneal 
dialysis. The lecture on charting included 
information on the specific sections of 
the chart, the use of medicine tickets, and 
the Kardex. 

The enthusiasm, not only of the 
pharmacy staff but also of the nursing 
staff was most encouraging to see as this 
program proceeded along its scheduled 
outline. Several of the nursing units 
cooperated in this joint venture and were 



pleased that they could help. Classrooms 
on the units were made available to our 
"students," the patients were prepared, 
and the nursing staff present to assist us. 
Pharmacists now have a better under- 
standing of the techniques and pro- 
cedures used on the nursing units. This 
program has also provided an opportunity 
for nurses to share their knowledge and 
problems. Nurses and pharmacists have 
come to know each other better and have 
taken a good hard look at their common 
"raison d'etre" - the care of the patient. 
- Sister M. Liguori, Director of Pharma- 
ceutical Services, St. Michael's Hospital, 
Toronto. 




I 



liss Archer, nursing student, demonstrates the technique of dressings to five pharmacists during a special course in which 

harmacists learned about nursing. 

MRCH 1969 THE CANADIAN NURSE 31 



Resources and use 
of CNA library 

The resources and services of the Canadian Nurses' Association's library support 
the Association's studies and consultation programs, and supplement the local 
library facilities that are available to members. 




CNA librarian Margaret Parkin adds a 
nursing cap to the display in the library 's 
archives collection 



Margaret L. Parkin, B.A., B.L.S. 

Why an article about libraries and 
library service, written by a librarian, in a 
nursing journal? Well, for many reasons. 

For one, nurses — in common with 
persons in all professions and many trades 
and occupations — have found that 
libraries are an integral part of their 
educational process, whether this educa- 
tion is undergraduate, graduate, or 
continuing. And, in today's world of 
rapid technological advances and socio- 
logical change, education is continuing 
and essential for the practice of any 
profession. 

Also, it has been customary in recent 
years to devote a page or two of the 
March issue of the Canadian nurse 
to libraries. A week in March used to be 
designated "Canadian Book Week," and 
many of us regret that this practice was 
discontinued, even though it can truth- 
fully be said that every week is "Book 
Week." 

Finally, the CNA hbrary is now in its 
fifth year of service. Although its re- 
sources and services have grown rapidly 
and are well used from coast to coast and 
around the world,* there are still those 
who ask "How do we use the CNA 
library? " "What services does the CNA 
library provide? " 

*In 1968, some 3,000 items were borrowed 
from the library, 1,200 reference requests were 
processed, and more than 2,500 copies of 
bibliographies were distributed. 

Miss Parkin is Librarian, Canadian Nurses' 
Association, Ottawa, Ontario. 



32 THE CANADIAN NURSE 



What is library service? 

To repeat the definition used in these 
pages in March 1966, a library is a 
collection of books, periodicals, doc- 
uments, and other printed, written, or 
audiovisual materials systematically 
organized and made available for use. The 
"use" may be recreational, educational, 
or informative. The librarian is defined as 
a custodian and purveyor of library 
materials; she is liaison officer between 
the library materials and the library users. 
The "users" vary from the population of 
a city who use a public library, faculty 
and students who use a university Hbrary, 
and members, students, or researchers of 
a profession who use a library such as the 
one at CNA House. 

How are library materials made availa- 
ble for use? Many people are convinced 
that librarians gather all kinds of useful 
information and materials and hide them 
away so that only librarians can find 
them. They also believe that librarians 
want all the books in the library in tidy 
rows on the shelves. These people are, of 
course, wrong. The librarian's main objec- 
tive is to make the hbrary resources 
available for use. Her methods of a- 
chieving this objective vary, depending on 
the particular materials, their monetary 
value, and whether or not they need to be 
on hand for constant and ready con- 
sultation in the library. 

Circulation and reference are the two 
basic forms of library service to users. 
They are basic to almost all libraries - 
public, university, industrial, and special 
- in varying degrees. 

The circulation service makes items 

MARCH 1969 



available for users to borrow and to take 
away from the library for specified 
periods of time. The more items in 
circulation, the better is the library ser- 
ving its users. 

Directories, almanacs, yearbooks, en- 
cyclopedias, large or many-volumed 
dictionaries, atlases, and such material are 
generally made available by reference 
service. They may not be taken away 
from the library, since they are required 
for immediate consultation, either by the 
user directly, or by the library staff on 
behalf of users. 

What are the CNA hbrary resources? 

A final preliminary to discussing 
CNA's library service is a brief outline of 
the library's role and resources. 

The CNA library is a special library, a 
national nursing library. TTiis role governs 
the selection of library materials, since its 
resources must include documentation 
and archive material about, or affecting, 
nursing and nurses in Canada, and nursing 
in other countries from which foreign 
nurses may come to Canada, or where 
Canadian nurses may serve. It is a re- 
search library rather than a teaching 
library. Nursing education and research, 
nursing service, and the economic and 



social welfare of nurses are emphasized 
and the holdings in the clinical areas are 
representative, rather than comprehen- 
sive. To support national office con- 
sultant and statistical services and the 
work of CNA committees, there are 
considerable holdings in sociology, sta- 
tistics, labor relations, and higher edu- 
cation. 

CNA's library has always been bi- 
lingual, with holdings in the English and 
French languages, catalogued in the 
language of source. The periodical racks 
at the entrance to the library, as well as 
those in the reading room, hold at least 
75 journals with French titles; many 
other journals are bilingual. The reference 
shelf at the reading room door has 
French- and English-language reference 
tools, and all the shelves in the reading 
room are marked in both languages. 

TTie first collection on the Ubrary 
shelves is the excellent series published by 
Les Presses Universitaires de France, the 
Que sais-je? series. It is very difficult to 
find French-language texts in nursing 
suitable for Canadian practice. However, 
many more clinical texts are purchased in 
the French language than in English, so 
that the faculties of schools of nursing 
can examine them and determine their 



suitability for use in Canada. Canadian 
government documents are either biling- 
ual or are procured in both French and 
English editions. Two years ago, a 
mimeographed list of the library's 
French-language material numbered 155 
items. There are considerably more now. 

Returning to the collection as a whole, 
there are some 6,500 books and docu- 
ments, classified in the National Library 
of Medicine** system. In addition, there 
are extensive vertical file holdings of 
pamphlets, newspaper clippings, and 
similar uncatalogued "short-life" 
material. 

The library has about 350 periodical 
subscriptions, the majority of which are 
health science journals and news bulle- 
tins; a few deal with public relations, 
journalism, labor relations, and library 
science. About 50 journals of other 
national nursing organizations are receiv- 
ed in exchange for either L'infirmiere 
canadieniie or the Canadian nurse 
Indeed, a major portion of the periodical 
collection is received on an exchange' 
basis. 

There are two special collections in the 
CNA Library. The Archives Collection 
contains documents and reports covering 
the history and activities of the Associa- 
tion, and books, documents, letters, 
photographs, and artifacts related to nurs- 
ing in Canada. The CNA Repository 
Collection of Nursing Studies includes 
studies about nursing in Canada, or 
studies by Canadian nurses. In addition to 
reports by government commissions and 
departments, hospitals and other insti- 
tutions and organizations, there are 
doctoral theses and papers written by 
students completing masters' degrees. 
This collection, which contains about 300 
studies, is rapidly becoming a major 
resource for nursing research in Canada. 

Associated with this collection, the 
CNA has prepared an Index to Canadian 
Nursing Studies. This index, which is 
presently being revised, covers studies in 
the same categories as the CNA reposito- 
ry Collection, but includes all studies that 
have been identified, not just those that 
are in the Collection. 

The Reference Collection contains the 
usual language and medical dictionaries, 
directories, almanacs, encyclopedias, and 
university calendars. A large number and 
a wide variety of index and abstract 
journals are also found in this section. 



**The National Library of Medicine in 
Washington, the major health science library in 
North America, was referred to recently as the 
"computerized central medical library in Wash- 
ington" which CNA should emulate. However, 
as mentioned in the library article in the March 
1968 issue of the Canadian nurse, the Ca- 
nadian government has authorized a National 
Medical (essentially Health Science) Library, 
The library has about 350 periodical subscriptions, most of which are health science which is now developing under the auspices of 
journals and news bulletins. the National Science Library. 

MARCH 1969 THE CANADIAN NURSE 33 




These include Hospital Literature Index, 
Hospital Abstracts, Abstracts of Hospital 
Management Studies, the Glendale Cumu- 
lative Index to Nursing Literature, the 
International Nursing Index, Canadiana, 
the Canadian Periodical Index, the Can- 
adian Education Index, Index Medicos, 
and the National Library of Medicine 
Current Catalogue. Reference resources 
also include biographical files on Can- 
adian nurses, reports, bylaws and per- 
sonnel policies of provincial nurses' as- 
sociations, provincial and federal legis- 
lation affecting nurses, and data on nurs- 
ing in other countries. 

Audiovisual Resources are limited for 
many reasons. Audiovisual aids generall;^ 
are designed to support specific education 
programs and thus are beyond the role of 
the CNA library at this time. Although a 
central library of audiovisual materials 
sounds desirable, the quantities required 
to support all Canadian schools of nursing 
would be extremely large. Such resources 
would be expensive to assemble, and a- 
loan service also would be costly. 

The CNA library does have catalogues 
of audiovisual aids from many agencies 
that are helpful in finding available mate- 
rials. The library also has sets of slides 
prepared by the League of Red Cross 
Societies on nursing history. These slides 
are in almost constant use by schools of 
nursing. Copies of CNA-sponsored films 
are, of course, on deposit in the Archive 
collection, but the loan service is carried 
on by an outside agency. 

Finally, mention must be made of that 
invaluable library resource shared by 
most hbraries, the Inter-Library Loan 
System. This service is not limited to 
nursing, and is immensely helpful in 
extending an individual library's re- 
sources. The federal government's 
National Library of Canada on Wellington 
Street in Ottawa maintains a National 
Union Catalogue to which major libraries 
in Canada report their holdings. By means 
of this catalogue, material required for 
serious research and study may be located 
and borrowed on inter-Ubrary loan. 

How is the lo.in service used? 

Each month, a list of recent library 
accessions, that is, books and documents 
that have been added to the library 
holdings, is published in the 
CANADIAN NURSE and L'infirmiere 
canadietine. Near the accession list is a 
coupon that readers can clip out to 
request items they would like to borrow. 
These requests are filled as much as 
possible in order of receipt. Books and 
documents are sent out on loan for two 
weeks with provision for maiUng time. 
The only cost to the borrower is the 
postage for return mailing. 

Extension of the loan period can be 
requested; the request is granted, if abso- 
lutely necessary. However, prompt return 
of borrowed material ensures that as 

34 THE CANADIAN NURSE 



many borrowers as possible can have the 
material without waiting too long. Books 
and documents, other than accession list 
items, also can be requested by mail. If 
the required material is in the library's 
holdings, it will be sent on loan as soon as 
possible. If not, the CNA hbrary, through 
the National Library of Canada, tries to 
find a library in Canada that has the 
material, and advises the would-be bor- 
rower. 

As mentioned earlier, some categories 
of library material, reference, and archive 
items, must be used in the CNA library 
and are not available for loans outside 
CNA House. Studies from the CNA 
Repository Collection are loaned only on 
an Inter-Library Loan basis. Individuals 
ask their own institutional, public, or 
university library to obtain the required 
study for them. The borrowing library is 
then responsible for its safe custody and 
return. Periodicals are also in the "cannot 
leave CNA House" class. However, single 
Xerox copies of articles requested are 
supplied and a minimum charge is made 
to cover the operator's time and the. 
paper used. Xerox copies of articles 
published in North American journals in 
the current year are not suppUed since 
these, presumably, are still available from 
the publisher. 

How Is reference service used? 

Users in the Ottawa area, and re- 
searchers and graduate students from 
out-of-town come to the library to use 
the reference resources, especially for 
extensive searches and studies. In addi- 
tion, library staff give reference service by 
telephone and by mall. Reference ques- 
tions range from addresses of schools of 
nursing and names of directors to lists of 
material on a topic or area of study. 

A bibliographic service has developed 
as a result of these requirements for lists 
of reference material. Some 50 standing 
bibliographies have been compiled and 
are updated from time to time, depending 
on user demand. Many reference ques- 
fions are answered by sending a biblio- 
graphy. The user can then request any 
material of interest that is not available in 
a local library. 

The library staff is small. Because of 
this, it is not always possible to do an 
extensive reference search immediately or 
to supply reference material by return 
mail. However, if there is a specific 
deadline for the material, every effort is 
made to meet it. 

As in the case of loans, library staff 
search beyond the resources of the CNA 
library for information required for re- 
search and similar studies. Under- 
graduates are guided to sources of in- 
formation instead of being supplied with 
data that is probably available in libraries 
in their own areas. They are encouraged 
to learn how to search and where to 
search. 



Who uses CNA library services? 

As indicated earlier, this library, 
located in the headquarters of the Can- 
adian Nurses' Association, belongs to 
Canadian nurses. It is a library for CNA 
national office staff and the Association's 
membership everywhere across Canada 
and around the world. Its resources are 
used by nurses in public health units, 
hospital nursing services, by faculty and 
students in schools of nursing, by gradu- 
ate students and other research workers, 
by consultants in government health 
departments, and by non-Association 
members with a need for information 
about nursing. 

Are consultation services available? 

The CNA library is not, as mentioned 
earlier, a teaching or cUnical library. Its 
resources are intended to supplement, not 
to replace, library facilities available to 
nurses in their working or learning situ- 
ations. 

Every encouragement is given to librar- 
ians who hope to establish and develop 
good library resources for nurse practi- 
tioners and nursing education. This en- 
couragement is provided by giving con- 
sultative service by mail, or through 
library orientation sessions to the librar- 
ians, who are generally non-professional. 
Last year, 1 4 day-long sessions were given 
at CNA House. The CNA Ubrarian was 
senior resource librarian for two, five-day 
workshops for non-professional librarians, 
sponsored by provincial nurses' associa- 
tions in the Maritimes and in the Prairie 
provinces. D 



MARCH ^%9' 



Canada's rare blood bank 



With the increase in the number of blood transfusions in the past few years, 
some extremely rare blood types have been identified. The Red Cross and the 
National Defence Medical Centre have both a file on and a storage unit for 
these rare types. This article describes this service. 



Len Carter 



In a hospital in Singapore in August 
1968, a Gurkha soldier serving with the 
British forces lay seriously injured. He 
needed a blood transfusion to save his 
life. 

But the type of blood he needed was 
very rare. Called Bombay Oh. it was 
discovered in the Bombay, India, area in 
1952, and even there its incidence is only 
one in 13,000. In Caucasians it is ex- 
tremely rare. 

A distress signal went out to the World 
Health Organization. A check of the 
International Rare Donor File of that 
organization revealed that the only 
Bombay Oh available was stored at Can- 
ada's rare blood bank at the National 
Defence Medical Centre in Ottawa. 

The emergency call was relayed to 
Canadian Red Cross headquarters in 
Toronto, which in turn notified the rare 
blood bank in Ottawa of the critical 
situation. That evening the only two units 
of Bombay Oh stored in the bank were 
on their way to Toronto in a container 
surrounded by tins of ice and packed in a 
heavy duty cardboard box. The next 
morning it was flown to Tokyo and from 
there to Singapore. 

Some while later the Red Cross report- 
ed that the Gurkha soldier had pulled 
ihrougli nicely, thanks to Canada's rare 
olood bank and to an anonymous donor 
n St. John's, Newfoundland, the only 
egistered donor of this rare blood type in 
Canada. 

Only the "very rare" types 

The Bombay Oh that saved a life 
lalfway round the world is only one of 
50 extremely rare blood types deep 
MARCH 1969 



frozen at Canada's only rare blood bank, 
in Ottawa. These rare types include one 
from a donor whose blood type is at 
present the only one of its kind known. 

Concrete plans for the rare blood bank 
began in April 1964, although experi- 
ments had begun as early as 1962. Plans 
involved the National Defence Depart- 
ment, the National Health and Welfare 
Department, and the Defence Research 
Board. The project, an outcome of a 
study on the military application both of 
rare blood types and of freezing blood for 
storage, was completed in January 1965. 
In August 1966 the National Defence 
Medical Centre was officially designated 
the rare blood bank for Canada, jointly 
involving the National Defence Depart- 
ment and the Canadian Red Cross Trans- 
fusion Service. The blood bank is under 
the direction of Dr. R.K. Smiley and Dr. 
W.J.Wills. 

By mid-September of that year there 
were 24 units of rare blood in storage. At 
present, there are approximately 80. The 
storage unit can handle 125. 

The Medical Centre handles the pro- 
cessing and storage while the Red Cross 
acts as the supply and issuing agent. Red 
Cross depots across the country file the 
names of Canadians found with rare 
blood. All these names are then cata- 
logued at the Society's head office in 
Toronto and it is decided which blood 
types are rare enough to ask for a special 
collection for storage, either for possible 

Mr. Carter is a medical reporter for The Ottawa 
Journal and a freelance writer, and has three 
stories cunently under production with the 
Canadian Broadcasting Corporation. 



world-wide use or for personal use in an 
emergency or during elective surgery. 

Units (500 cc.) of those rare enough 
for banking are collected by the Red 
Cross and are sent to the bank — usually 
by air — to be processed for deep 
freezing. 

Donations of blood of more common 
types are stored at just above freezing at 
the local depots and must be used within 
three weeks; deep frozen blood may be 
kept as long as five years or even longer, 
but at present deep freezing is too ex- 
pensive for anything but the rarest types. 

Rare blood sent anywhere in the world 
or Canada is released through the Red 
Cross's Toronto office. 

To date, people with blood rare 
enough for collection have been found in 
all but three provinces. For instance, 
there is an Indian living west of Edmon- 
ton with an extremely rare type, which 
Dr. Biro calls -D-, -D-. Part of a 
chromosome in this man's blood cells is 
missing. 

The Red Cross's national rare blood 
file recently proved its value when four 
pints of one of the rarest blood types in 
the world were needed to save the life of 
a newborn baby girl in Oshawa, Ontario. 
Two women in Nova Scotia and one in 
Northern Alberta were known to have the 
same blood type according to Red Cross 
files; they combined through their blood 
donations to help save the life of the 
infant. 

Special process for long-term storage 

At the rare blood bank, the key piece 
of equipment used in processing blood 
for freezing and later reconstitution is the 

THE CANADIAN NURSE 35 




Warrant Officer B.S. Wambolt prepares a pack of red blood cells for freezing at the 
National Defence Medical Centre's rare blood bank. Warrant Officer Wambolt 
reconstituted the rare Bombay O^ blood that was shipped to Singapore last August to 
save the life of a Gurkha soldier serving there. 



Muggins Cytoglomerator. It was devel- 
oped by Dr. Charles Muggins, a professor 
of surgery at Boston's Massachusetts 
State Mospital. 

Priced at about SI 0,000, it is the only 
one in Canada and as far as is known 
there are only four or five others in the 
world. Two are being used in Vietnam 
and another aboard a specially equipped 
United States destroyer. 

The Cytoglomerator separates off 
plasma, leaving about 300 cc. of cells. 
These cells are put in a plastic sleeve 
about three feet long and mixed with a 
glycerol solution; the cells can then be 
frozen without damage. 

The suspended cells are then spread 
along the length of the sleeve, which is 
folded and placed in a carton. The carton 
goes into the deep freeze unit at minus 85 
degrees centigrade - the temperature of 
dry ice or four times as cold as a home 
freezer. 

When an emergency call comes in for a 
certain type of blood on hand, the frozen 
cells are thawed at 40 degrees centigrade 
and put back on the Cytoglomerator - 
which can handle five units at a time 
when necessary — where the cells are 
cleansed of the protective glycerol solu- 
tion by washing them three times in a 
sugar solution. 

The final step is to suspend the cells in 
a saline solution - or in the original 
serum, which also can be frozen - and 
bag the results in a plastic pack connected 
to the original sleeve. The pack is used to 
administer the transfusion. Frozen cells 
can be reconstituted for shipment in 40 
minutes. 

36 THE CANADIAN NURSE 



Finding rare types 

Dr. Biro explained that many people 
think they have quite ordinary blood 
types according to the two primary 
methods of blood typing, and may not 
discover otherwise until they either 
donate blood or enter a hospital for 
surgery. The two primary methods of 
blood typing are the ABO system, first 
described by Landsteiner in 1900, and 
the D factor typing, which gives the Rh 
positive or negative reading. 

At Red Cross donor clinics, according 
to a senior technician at the Ottawa 
donor clinic, whenever they discover a D 
negative reading, they also check to see if 
the donor is negative to two other factors 
" C and E. 

However, says the technician, it is 
more often that a person discovers he or 
she has a rare blood type through the 
extensive cross-matching done in a hospi- 
tal prior to surgery. 

Only this cross-matching process, 
either major or minor, searches out blood 
type rarities. The minor cross-match 
detects antibodies in the serum of the 
donor's blood that are capable of effect- 
ing the recipient's blood cells. As the 
donor antibodies are greatly diluted by 
the recipient's plasma, however, they are 
considered of "minor" importance. The 
major cross-match is the more important 
of the two because it detects antibodies 
in the serum of the recipient, which may 
damage or destroy the red cells of the 
proposed donor. 

Medical science says there is no posi- 
tive reason for blood rarities other than 
genetic variation and the fact that blood 



types are not restricted to any particular 
race. 

Blood type rarity. Dr. Biro says, 
depends on the presence or absence of 
antigens on the red cells. The antigens 
build up antibodies in the blood serum 
against donated blood unless the red cells 
of the donated blood have identical anti- 
gens. 

Once a person discovers he has an 
extremely rare blood type, he should 
consider donating blood to the Red Cross 
and having it stored against the day when 
a transfusion miglit be needed. An Otta- 
wa doctor with a rare blood type has a 
bleeding ulcer; he has donated blood to 
the Red Cross and it is deep frozen as 
kind of an insurance should he hemor- 
rhage or require surgery for another 
reason. 

Mowever, in most cases there is no 
guarantee that your rare blood type may 
not be shipped out in answer to an 
emergency call to save a hfe in the Outer 
Hebrides before you require it. 

Frozen blood more useful 

The value of deep freezing is not 
hmited to preserving rare blood types for 
long periods. Reconstituted, deep frozen 
blood of any type survives better in the 
body of the recipient when transfused. 
Freezing suspends the aging process — 
each day l/120th of our red blood cells 
die and are replaced by new cells — and 
frozen blood when transfused even years 
later is as fresh as the day it was 
collected. 

According to Dr. Biro, there is a 
greater safety factor in frozen blood. For 
instance, hepatitis, a virus infection of the 
liver, can be transmitted from one person 
to another through transfusion of blood 
stored in the normal manner. Frozen 
blood. Dr. Biro says, eliminates this and 
other hazards. 

Because there is less reaction to frozen 
blood, he would like to see it used in 
critical transfusions. Frozen blood has 
been used extensively in organ transplant 
surgery to reduce the possibility of re- 
jection. 

It is very likely that when the deep 
freezing process has become less costly 
and less time consuming, all future blood 
donations will be deep frozen until need- 
ed for transfusion. One of the many 
advantages will be to eUminate the crisis 
often faced by hospitals when there is a 
shortage of donor blood. Q 



MARCH 1969' 



A dollar^ a dollar^ 
follow the scholar 



Last May, THE CANADIAN NURSE presented an article about Dorothy ). Kergin 
a 1967 recipient of Canadian Nurses' Foundation funds who was studying tor tne 
doctor of philosophy degree at the University of Michigan in Ann Arbor. 
Now, almost a year later, the editor of CNJ "follows the scholar" to her new 
home in Dundas, Ontario, and to her place of employment, McMaster University's 
School of Nursing in Hamilton, and talks to her about her responsibilities as 
associate director of nursing. 



Dr. Dorothy Kergin, in plaid slacks 
and a comfortable-looking ski cardigan, 
pointed out various landmarks, including 
McMaster University, as she drove us 
from the airport limousine depot in 
Hamilton to her apartment in Dundas. It 
was a bright Sunday morning in mid- 
winter, and Dorothy's pleasure at living in 
this small suburban community, two 
miles distant from the university, was ev- 
ident. 

"We even have a mountain here," she 
said, referring to the 250-foot-high Niag- 
ara escarpment — known affectionately 
by the natives as "The Hamilton Moun- 
tain." "And we're far enough from the 
city to avoid the usual traffic problems, 
yet close enough to allow us to take 
advantage of the amenities of city life," 
she added. 

Dorothy settled into her Dundas 
apartment and her role as associate direc- 
tor of McMaster's School of Nursing early 
last September, after completing a three- 
year doctoral program at the University 
of Michigan in Ann Arbor. She received 
her Ph.D. degree in December, and ad- 
mitted that the ceremony was one of the 
most exciting experiences in her life. "My 
friends tell me that I really 'lost my cool' 
on graduation day," Dorothy chuckled, 
"because 1 kept asking where my car keys 
were — as I clutched themin my hand! " 

Most of Dorothy's nursing career 
before attending the University of Michi- 
gan was spent in public health in her 
home province, British Columbia. 
(Readers will remember Dorothy as the 
public health nurse with a rather unusual 
reputation: when stationed at Princeton, 
MARCH 1%9 



V.A. Lindabury 

B.C., she went routinely to the Copper 
Mountain mining area in her district "in 
search of disease and affection" — a quest 
accorded her by an imaginative young 
Copper Mountain schoolboy in his essay 
on "What the Public Health Nurse Does 
When She Comes to Town.") 

Three main responsibilities 

"I have three main responsibilities at 
McMaster," Dorothy explained, as we sat 
in her modern, eighth-floor apartment 
sipping our second cup of strong coffee. 
"I teach public health nursing and coordi- 
nate the students' clinical practice in 
public health; serve as associate director 
of the school, working with Alma Reid, 
the director; and have some responsibility 
for research. Actually, I haven't had time 
as yet to even think about research," she 
added, "but I hope to remedy that in 
March, after my teaching responsibilities 
are over for the year." 

Until mid-December, Dorothy taught 
public health nursing theory to the 28 
students in the final year of the basic 
baccalaureate degree program in nursing, 
and supervised the activities of 10 of 
these students in the Hamilton- 
Wentworth Health Unit. Her lectures 
ended in December, and she and her 
students spent considerably more time in 
the clinic^ setting in January and Febru- 
ary. 

When not teaching, Dorothy usually 
can be found at a committee meeting. 
One committee she is on meets regularly 
to make plans for the new school of 
nursing, scheduled to open in the fall of 
1970. "Our school will be part of the 



Health Sciences Center," Dorothy ex- 
plained, "and will be housed in the new 
University Hospital, along with the med- 
ical school. We'll probably be able to 
more than double our yearly student 
enrollment, which is now limited to 30 
because of lack of facilities." 

Dorothy is chairman of an interdisci- 
plinary committee set up to explore 
opportunities for joint activities for stu- 
dent education, and to clarify some of 
the role relationships among members of 
the health professions. "These meetings 
are quite stimulating," she said, "prob- 
ably because each representative from 
nursing, medicine, and social work has a 
different idea about the proper role of 
persons on the health team, and isn't 
afraid to voice it." 

We asked Dorothy what other respon- 
sibilities she had at McMaster. 

"Well, I'm in charge of public relations 
for the school of nursing," she said, "and 
in future will be working closely with the 
Health Sciences Center's new public rela- 
tions officer. As part of this, one of my 
responsibilities this year is to update the 
school of nursing's calendar." 

This year, Dorothy is helping to make 
arrangements for nurses from abroad who 
wish to visit McMaster University School 
of Nursing before attending the Inter- 
national Council of Nurses' Congress in 
Montreal in June. "We're working closely 
with the Registered Nurses' Association 
of Ontario and schools of nursing in 
Hamilton in planning a short program on 
nursing education immediately prior to 
ICN," she said, "and we'll probably be 
arranging visits for a few nurses after the 

THE CANADIAN NURSE 37 




Dorothy Kergin (center) looks at the architect's plans for the Weekly seminars are held so that students can discuss problems 

new Health Sciences Center, with Alma Reid (right), professor they have encountered in giving public health care to the 

and director of McMaster School of Nursing, and Henrietta families assigned to them. This seminar is chaired by Dr. Kergin. 
Alderson, associate professor. 



Congress." 

In her spare time, Dorothy is writing 
part of a chapter for a booic that will be 
published by the University of Toronto 
School of Nursing to commemorate its 
50th anniversary in 1970. She will in- 
corporate some of the findings from her 
doctoral thesis into her writing. 

Enjoys the university "atmosphere" 

As we ate lunch, Dorothy talked about 
her Ufe as a faculty member, reminding us 
that this was her second experience at 
university teacliing. Immediately before 
embarking on her doctoral program, she 
had taught public health nursing at the 
University of Michigan. 

"It's stimulating to work with students 
at this level," she said. "You really have 
to be on your toes and keep up-to-date 
with everytliing. I came to this school, 
which offers a basic baccalaureate pro- 
gram, because I believe the graduate of 
such a program is the foundation upon 
which we should be building our profes- 
sion. 

"And I enjoy the university atmos- 
phere," Dorothy added. "There are 
plenty of educational opportunities here 
that staff can take advantage of, such as 
various lecture series, and it's interesting 
to be associated with people in other 
disciplines who have similar interests in 
education, yet different backgrounds and 
points of view." 

Dorothy said that her doctoral pro- 
gram has given her considerable under- 
38 THE CANADIAN NURSE 



Standing of the organization of univer- 
sities and the relationsliips and respon- 
sibilities that exist within the university 
structure. "When certain things happen 
here, I can think back and see the 
rationale for them, so in this way the 
doctoral studies were helpful. In another 
way, just the broadening of one's back- 
ground and understanding of other disci- 
plines — sociology and psychology, for 
example — is extremely helpful to any 
teacher. 

Enthused about CNF 

Dorothy is a staunch supporter of the 
purposes of the Canadian Nurses' Foun- 
dation. As she told us before, she could 
not have stayed at school to complete her 
doctoral degree, if she had not received 
financial assistance from CNF. 

When we reminded Dorothy of CNF's 
financial plight (to date, only $25,000 is 
available for 1 969 fellowship awards, less 
than half the amount awarded in each of 
the past two years), she suggested that 
the present two-dollar membership fee 
should be increased. "Personally, I would 
have no objection to paying a larger fee," 
she said, "and I think that most people 
who are members, who are committed to 
the concept that there should be a Can- 
adian Nurses' Foundation, will continue 
to support CNF, even if the membership 
fee is increased. 

"Why not publish an article on wills 
and bequests, and put a bequest form for 
CNF in THE CANADIAN NURSE? Dorothy 



asked. "This might encourage nurses to 
will money to the Foundation. Too 
often, women don't bother making wills, 
because they don't have families." 

Dorothy also believes that the federal 
government must be convinced of the 
need for more traineeships for nurses. "I 
believe that, in future, lobbying will be an 
important role for the Canadian Nurses' 
Association," she said. "A full-time CNA 
lobbyist would be able to keep the 
government informed of the Association's 
viewpoints, and could also keep the 
nursing profession aware of pending legis- 
lation and its implications for nursing." 

Back with people 

Last year, when Dorothy was comple- 
ting her dissertation for her doctoral 
degree, she felt rather isolated, because 
the demands of her studies cut her off 
from her usual contacts with friends and 
colleagues. This year, she is back with 
people and enjoying it. And we have a 
strong suspicion that the people Dorothy 
works with are more than pleased to have 
this former CNF scholar in their ranks. 

Membership in the Canadian Nurses' Foun- 
dation can be obtained by sending your name, 
address, and cheque for two dollars to: CNF, 
50 The Driveway, Ottawa 4. Donations in 
addiiion to the two-dollar membership fee are, 
of course, welcome. Membership fee and dona- 
tions are tax-deductible. Q] 



MARCH 1969 



New services help 
patients and staff 



A description of two new services — a day nursery for the children of the 
hospital staff and a consultation clinic for outpatients — at Montreal's 
Santa Cabrini Hospital. 



Nicole Beaudry-Johnson 

To attract married women back to 
nursing, some hospitals in Canada have 
set up their own day nurseries to care for 
the children of members of staff. The 
Jardin Cabrini, at the Santa Cabrini 
Hospital in Montreal, is the first such day 
nursery to be set up in the Province of 
Quebec. 

Reverend Mother Sylvie of the 
Missionary Sisters of the Sacred Heart, 
the present superior of Santa Cabrini 
Hospital, says that the day nursery re- 
lieves the working mother of many 
worries concerning the care of her child. 
The mother's worries about leaving the 
child with an unknown babysitter, a 
neighbor, or a relative are eliminated: she 
knows, too, that the child will receive 
prompt treatment if he becomes ill. 

Everything scaled down 

The day nursery occupies large quar- 
ters close to, but outside, the hospital's 
center of activity. Everything is scaled 
down to a child's size so that furniture, 
drinking fountains, and bathrooms are 
the right height for the child's comfort 
and protection. Even the elevator has 
been installed without buttons so that 
even the most imaginative child cannot 
operate it alone. A dining hall, a dormi- 
tory, a playroom, a classroom, an infir- 
mary, and a small waiting room for the 
mothers are included in the day nursery 
complex. 

For a modest weekly fee, the tots 

Mine Beaudry-Johnson is Associate Editor of 
L 'infirmiire canadienne. 



MARCH 1%9 



spend their day under the same roof as 
their mothers and receive the same care as 
they would in the more expensive, private 
day nurseries. Four competent attendants 
- a nursery school teacher, a nun, and 
two assistants look after their needs. 
The nursery school teacher works from 
9:30 to 11:30 a.m. and from 2:00 to 
4:00 p.m. 

The children enjoy music, painting, 
singing, handicrafts, and, in summer, 
various games that can be played outside 
on the hospital's large stretch of lawn. 
They get a hot meal at noon and two 
snacks during the day. After dinner, they 
have a rest period. 

Toddlers are admitted to the day 
nursery as soon as they are toilet trained, 
and can attend until they are six. On 
registration, all children are seen by a 
doctor. The mother can bring her child in 
as early as 7:30 a.m., and can leave him 
until 5:00 p.m., giving her time to shop if 
she wishes. 

Increase in services 

When the day nursery opened its doors 
in September 1968, there were 40 regis- 
trations. Mother Sylvie expects the 
number to increase, and says she hopes 
the service will soon be available for 
school-age children. These children would 
get their noonday meal at the day nursery 
and would return there after class to wait 
for their mothers. Mother Sylvie also 
expects that the nursery will be able to 
accommodate the children of other work- 
ing mothers in the neighborhood in the 
near future. 

THE CANADIAN NURSE 39 




Consultation clinics 

Santa Cabrini Hospital's outpatient 
clinic, which opened last July, operates 
on the same principle as a doctor's office, 
and offers all the advantages of the 
available hospital services. 

Patients come to the clinic on ap- 
pointment, thus eliminating the long 
waiting periods that are so typical of 
most hospital outpatient departments. 
According to clinic coordinator Dr. John 
Xenos, most patients who come to the 
clinic are without a family doctor or, 
having seen a doctor, are dissatisfied with 
the results. Many patients are immigrants 
who do not know where to go for 
medical assistance. An interpreter, who 
speaks several languages, helps these 



people to communicate their problems to 
the doctor. The clinic seems to be a 
success, as the number of patients attend- 
ing has tripled since its opening. 

Primary contact 

The new clinic is composed of many 
units, including prenatal clinics, clinics 
for dental surgery and oph"thalmology, 
orthopedic, cardiology, and internal 
medicine clinics, and a department of 
audiology. 

A patient who attends the outpatient 
clinic is examined by the "primary con- 
tact" doctor - a general practitioner - 
who sees him again or refers him to a 
specialist according to his need. Four 
general practitioners are on duty from 




Santa Cabrini Hospital, designed by the 
Italian architect Pellegrino De Sina, is one 
of the most modern and best-equipped 
hospitals in Montreal 



8:30 a.m. to 3:30 p.m. Monday to 
Friday. Specialists are on rotation duty, 
and each day of the week is reserved for 
consultations in a given specialty. Night 
calls, when urgent, are referred to the 
emergency clinic. 

The primary contact doctor treats 65 
percent of the patients, according to 
statistics made available by Dr. Giallo- 
reto, who is Chief of Staff and in charge of 
medical teaching at Santa Cabrini Hospi- 
tal. If a patient is referred to a specialist, 
he later returns to the primary contact 
doctor for further care. 

Nurse's role 

Irene Pelletier, assistant head nurse at 
the outpatient clinic, explained that the 
nurse's main role in the clinic is to 
welcome the patient and calm his fears. 
"For some reason," she said, "the patient 
generally feels more anxious than he 
would if he had gone to the doctor's 
office. The surroundings are new to him. 
We must be smiling, calm, and patient." 

There are three nurses on duty at the 
outpatient clinic. According to Miss Pelle- 
tier, their work is similar to that carried 
on in a doctor's office. "We record the 
patient's weight and height, chart his vital 
signs, and take blood samples for labora- 
tory analysis. 

The clinic nurses make certain that the 
patient's records are complete, and make 
a follow-up appointment for him. If the 
patient is in financial difficulties, the 
nurse refers him to the department's 
social worker: otherwise the patient pays 
for his visits. □ 



40 THE CANADIAN NURSE 



The hospital's day nursery relieves the 
working mother of her worries about the 
welfare of her child 

MARCH 196S 



Nurses Can Give and Teach Rehabili- 
tation 2nd ed., by Mildred J. AUgire, 
R.N., R.P.T., M.A. 93 pages. New 
York, Springer Publishing Company, 
Inc., 1968. 

Reviewed by Charles Ball, Director of 
Nursing, The Perley Hospital, Ottawa, 
Canada. 

The second edition of this book, 
written primarily for those engaged in the 
care of the handicapped, is presented in a 
style that makes it easy and enjoyable to 
read. 

For those who need to be convinced 
of the values of rehabilitation, there is a 
very good introduction. This is followed 
by short but informative chapters on the 
prevention and treatment of com- 
plications in the chronically ill, emotional 
problems in patients with chronic disabih- 
ties, and nutrition in rehabilitation. 

A welcome addition to this second 
edition is the chapter on bladder and 
bowel training. 

A major portion of the manual is 
devoted to physical rehabilitation nursing 
care. General information is given on bed 
posture, and 16 basic exercises are de- 
scribed and illustrated. The importance of 
assigning orJy exercises that meet the 
individual patient's needs is stressed and 
the necessity for patient activity is clearly 
demonstrated. Rehabilitation in the home 
as well as in hospital is discussed. 

This manual would assist the student 
in understanding the role of the nurse in 
rehabilitation. 



Sex and Its Problems edited by WiUiam 
A.R. Thomson, M.D. 90 pages. Edin- 
burgh and London, E. & S. Living- 
stone Ltd., 1968. Canadian agent: 
Toronto, Macmillan Co. of Canada, 
1968. 

Reviewed by Dr. S.R. Laycock, Van- 
couver, B.C. 

This book, designed to help the family 
doctor in his understanding of sexual 
problems, contains a series of 12 articles 
written by medical men in Britain and 
pubhshed in 1967 in the British periodi- 
cal The Practitioner. The topics discussed 
include: sexual problems of adolescence, 
the impotent male, the frigid female, 
infertility in the male and female, artifi- 
cial insemination, sexual adjustment, and 
the climacteric and medical aspects of 
homosexuality and sexual perversion. 
MARCH 1969 



The articles are, on the whole, very 
readable. Unfortunately, the two most 
technical articles are the first in the book 
and are likely to discourage the non- 
medical reader. 

The book is of special value to medical 
students, general practitioners, student 
nurses, and graduate nurses. The intelli- 
gent layman would find the book in- 
formative. 



Urology for Nurses by J.P. Mitchell, T.D., 
M.S.(Lond.), F.R.C.S., F.R.C.S. 
(Edin.). 324 pages. Toronto, The Mac- 
millan Company of Canada, 1968. 
Reviewed by Frances M. Cochrane, 
Nurse-in-charge, Cystoscopy Room, 
Royal Columbian Hospital, New West- 
minster, British Columbia. 

This book is an excellent guide to the 
surgical aspect of urology. It is of interest 
not only to nurses working on a urologi- 
cal ward or in a cystoscopy cHnic, but to 
orderlies working with nurses in these 
areas. Detail about surgical operations 
and instruments has been ampUfied to 
cover the needs of the operating theatre 
staff. The size of this volume does not 
permit discussion of subjects such as 
nephritis or venereal disease, neither of 
which is now regarded as the respon- 
sibility of a nurse working in a depart- 
ment of urology. 

Although the art of nursing is largely 
one of practical application, it is always a 
helpful stimulus to know the reason for 
the various treatments prescribed and the 
operations performed. Furthermore, in 
these days when the Umits of our knowl- 
edge are extending so rapidly, frequent 
changes in methods of treatment will 
occur. Sometimes these changes may even 
appear to be a paradoxical reversal of 
basic principles. It is with this concept in 
mind that a certain amount of theory has 
been presented in this book, theory that 
may at first appear to be unnecessary for 
a nurse's education. Recent advances, 
such as the treatment of acute renal 
failure by dialysis, are described in some 
detail. More practical features, such as the 
management of a cystoscopy clinic, are 
also described in the belief that urology 
will develop as a specialty in most hospi- 
tals within the forseeable future. 

To the nurse who is interested in why 
and how compUcated investigations are 
done, to the nurse who wants a detailed 
guide to a cystoscopy clinic, or to the 



nurse who simply wants to learn the 
proper way to test urine, this book will 
be invaluable. The author has included 
every important detail while reducing 
theory to a minimum. He preaches simple 
common sense based on accurate knowl- 
edge. 

This book is well illustrated with 
halftone illustrations and photographs. It 
is especially valuable because of the limi- 
ted number of books available on this 
topic for use by nurses. 



Nursing Care in Eye, Ear, Nose, and 
Throat Disorders, 2nd ed., by William 
H. Saunders, B.A., M.D.; William H. 
Havener, B.A., M.S. (Opth.), M.D.; 
Carol J. Fair, R.N., M.S., and Joseph- 
ine T. Hickey, R.N.. M.S. 402 pages. 
Saint Louis, Mosby, 1968. 
Reviewed by Marcella MacDonald and 
Eileen Burgoyne, Eye, Ear, Nose, and 
Throat Department, Camp Hill Hospi- 
tal, Halifax, N.S. 

Section one contains 1 5 chapters on 
ocular disorders. Anatomy and physio- 
logy are discussed and an account of 
clinic examinations of eyes is given. The 
significance of various eye symptoms is 
particularly well covered and is followed 
by a brief account of drugs commonly 
usedJn the treatment of eye disease. 

The chapter on nursing care is good 
and certainly outlines current ideas of 
postoperative nursing care and the use of 
ophthalmic preparations. Refractive errors, 
injuries, infections, strabismus, glaucoma, 
cataract, and retinal detachments are each 
given a chapter, and all the conditions are 
adequately explained and the treatment 
principles described. 

A few of the less common eye diseases 
are described in Chapter 13. The last two 
chapters are devoted to the problems of 
blindness and attempts to dispel common 
misconceptions about eyes. 

This section is easily read and well 
illustrated, and represents an excellent 
basic text for any nurse caring for eye 
patients. It is higlily recommended and 
should be in every eye ward. 

Section two is devoted to disorders of 
the ear, nose, and throat. 

Anatomy and physiology, old and 
modern methods of medical and surgical 
therapy, and measures of prevention are 
explained clearly and logically. 

The authors' extensive use of illus- 

THE CANADIAN NURSE 41 



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42 THE CANADIAN NURSE 



trations effectively clarifies and comple- 
ments their pertinent information. It 
seems a pity, however, that Frank 
Netter's beautiful illustrations taken from 
Clinical Symposia have not been repro- 
duced in color. 

A glossary and a list of suggested and 
reference readings are also included. 

Particular emphasis is placed on nurs- 
ing procedures, patient teaching, and the 
physiological and emotional changes that 
the individual patient undergoes. 

This text provides an authoritative 
background to enhance nursing per- 
formance and maintain it at a high level 
of clinical competence, which, as stated 
in the preface, is the authors' aim. 

Storage of Blood by B.A.L. Hurn. 167 
pages. New York and London, Acade- 
mic Press, 1968. 

Reviewed by Dr. D.M. Wrobel, Medical 
Director, Canadian Red Cross Blood 
Transfusion Service, Toronto. 

This book brings a renewal of promise 
that the consolidated efforts of many 
scientists will establish long-term blood 
storage as a routine practice. As yet, there 
is no substitute for blood, and until there 
is it will always be regarded as a life-giving 
fluid. To fulfill its biological expec- 
tations, the red cells must be kept viable 
during storage. 

In this book, the author gives precise, 
up-to-date information with many in- 
valuable references and his own practical 
views on this fascinating subject. Each 
chapter opens yet another aspect of the 
blood transfusion. The author discusses 
with clarity the complexities of blood 
metabolism under various storage con- 
ditions, the effect of different anti- 
coagulants and purine nucleosides in re- 
lation to biological and biochemical de- 
gradation. Even under ideal storage con- 
ditions the limited life of blood creates 
acute shortages from time to time; this 
reflects the urgent need for long-term 
storage. The author evaluates the differ- 
ent methods and techniques of freezing 
and thawing blood for transfusion 
purposes, together with its practical im- 
plications in clinical medicine. The last 
chapters of the book deal with methods 
of red cell preservation for routine as well 
as research laboratory. 

A short review of the storage of other 
blood components - platelets, leuco- 
cytes, and plasma constituents - com- 
pletes the book. Anyone who is in any 
way connected with blood transfusion, be 
he clinician, pathologist, technician, or 
nurse, should read this excellent book. It 

MARCH 1969 



is well-written, with enofigh clear details 
that the uninitiated reader will feel no 
stranger in this field. □ 



accession list 



Publications on this list have been 
received recently in the CNA library and 
are listed in language of source. 

Material on this list, except Reference 
items, including theses, and archive 
books, that do not circulate, may be 
borrowed by CNA members, schools of 
nursing and other institutions. 

Requests for loans should be made on 
the "Request Form for Accession List" 
and should be addressed to: The Library, 
Canadian Nurses' Association, 50 The 
Driveway, Ottawa 4, 

No more than three titles should be 
requested at any one time. 

BOOKS AND DOCUMENTS 

1 . Adolescent psychiatry. Proceedings 
of a conference held at Douglas hospital, 
Montreal. Quebec, June 20, 1967, edited 
by S.J. Shamsie. Montreal, Schering Corp., 
1968. 84p. 

2. L'affrontement de I'inquietude par 



Guy Delpierre. Paris, Editions du Cen- 
turion, c. 1968. 302p. 

3. Aids and adaptations; a collection 
of designs compiled by the Canadian 
Arthritis and Rheumatism Society, Oc- 
cupational Therapy Department, Van- 
couver, B.C. Toronto, The Canadian 
Arthritis and Rheumatism Society, 1968. 
Iv. 

4. American universities and colleges. 
edited by Otis A. Singletary and Jane P. 
Newman. 10th edition. Washington, 
American Council on Education, cl968. 
1782p. 

5. Annual report of the Order of the 
Hospital of St. John of Jerusalem. Ot- 
tawa, 1967. 58p. 

6. Associated corporations in Canada. 
3d edition. Don Mills, CCH Canadian 
Ltd., 1965. 51p. 

7. Cavalcade in white; the story of 
nursing in Canada by Douglas H. Murray. 
(Play written for the Canadian Nurses' 
Association, 1958, Golden Jubilee). 64p. 

8. Clear writing by Leo Kirschbaum. 
Cleveland, World Publishing Company, 
1961,cl950. 376p. 

9. Deliberations; Conference cana- 
dienne du vieillissement, Toronto, 20-24 
Janvier 1966. Ottawa, Conseil canadien 
du Bien-etre, 1967. 114p. 

1 0. Effective revenue writing by Calvin 
D. Linton. Washington, U.S. Treasury 
Dept., 1962.2V. 



11. Exchange of ideas; 1966-196 7 
Conference of Nursing Advisory Service 
of NLN-NTRDA. New York, National 
League for Nursing, 1968. 1 14p. 

12. Experiments in second-language 
learning by Edward Crothers and Patrick 
Suppes. New York, Academic Press, 
1967. 374p. 

13. Facts about nursing; a statistical 
summary. New York, American Nurses' 
Association, 1968. 247p. 

14. Florence Nightingale. 1820-1910 
by Cecil Woodham-Smith. London, Con- 
stable, 1951, 1950. 61_5p. 

15. Guide for instructors; care in the 
home, rev. by National Nursing Services, 
Canadian Red Cross Society. Toronto, 
1967. 150p. 

16. Handbook of recovery room nurs- 
ing by Lucille 1. Betschman. Philadelphia, 
Davis, c 1967. 308p. 

17. Incorporation and income tax in 
Canada. 4th edition by Gordon W. Riehl. 
Don Mills, CCH Canadian Ltd., 1965. 
196p. 

\8. An introduction to the analysis of 
educational concepts, by Jonas F. Soltis. 
Reading, Mass., Addison-Wesley, cl968. 
lOOp. 

19. Learning and society, edited by 
James Robbins Kidd. Toronto, Canadian 
Association for Adult Education, cl963. 
414p. 

20. Man deserves man; CUSO in 
developing countries, edited by Bill 




• •I like the challenge 
of working in the vi- 
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Houston's Methodist Hos- 
pital — let me tell why 

t^ nurse 

Let"s tell it like it is. Most nurses who are free to locate 
anywhere they wish, want to be where medical history is 
being made. Nurses at Houston's Methodist Hospital have 
this sense of history being made — here and now. One nurse 
said, "... the research and well-known physicians, pa- 
tients from all over the world are interesting." 

"I consider the most exciting thing about working at 
Methodist Hospital the feeling that I'm in the middle of 
a place that is making medical history." says a Cardiovas- 
cular Nurse Specialist. 

Ten Basic Nurse Services. Methodist Hospital nurses do 
not rotate shifts and often improve their salaries and posi- 
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THE CANADIAN NURSE 43 



accession list 



(Continued from page 43) 



McWhinney and Dave Godfrey. Toronto, 
Ryerson Press, 1968. 461p. 

21. Management and Machiavelli by 
Antony Jay. London, Hodder and 
Stoughton,cl967. 223p. 

22. Pioneering in public health nursing 
education; the history of the University 
Public Health Nursing District 
1917-1962, by Eleanor Farnham. Cleve- 
land, Ohio, Press of Western Reserve 
University, 1964. 104p. 

23. Probings; a collection of essays 
contributed to the Canadian Mental 
Health Association for its golden jubilee 
1918-1968. Ottawa, Canadian Mental 
Health Association, 1968. 94p. 

24. A profile of physicians in the city 
of New York before medicare and 
medicaid by Nora Piore and Sandra 
Sokal. New York, Hunter College, 1968. 
208p. 

25. Psychiatric de I'adolescence; Con- 
ference tenue le 20 juin 1967 a ITjdpital 
Douglas, Montreal, P.Q., par S.J. Shamsie, 
redacteur. Montreal, Sobering Corp., 
1968. 91p. 

26. Research and investigation in adult 



education - 1918 annual register, edited 
by Roger DeCrow and Stanley Gro- 
bowski. Washington, Adult Education 
Association of the U.S.A., 1968. 79p. 

27. Sante et equilibre de I 'enfant, ■ 
guide des infirmieres et puericultrices, 
parente et educateurs par Florence Blake. 
Paris, Centurion, cl968. 202p. 

28. A study of a patient classification 
system by Wayne Reavely Moon. Ann 
Arbor, 1964. 90p. Thesis (M.H.A.) - 
Michigan. R 

29. Target 2067; Canada's second 
century by Leonard Berlin. Toronto, 
Macmillan,cl968. 297p. 

30. Towards collective bargaining in 
non-profit hospitals: impact of New York 
Law by Sara Gamm. Ithaca, N.Y., New 
York State School of Industrial and 
Labor Relations, 1968. 1 12p. 

31. What are the pay-offs from our 
federal health programs? a progress 
report on the Johnson administration, 
1963-1968. New York, National Health 
Education Committee, 1968. 71 p. 

32. Working with others for patient 
care by Grace Peterson. Dubuque, Iowa, 
Brown, cl 968. 140p. 



PAMPHLETS 

33. Collective bargaining techniques. 
Montreal, Montreal Board of Trade, Em- 
ployee Relations Section, 1967. lOp. R 

34. Folio of reports, forty-seventh 



annual meeting, Oct. 22, 1968. Charlotte- 
town, Association of Nurses of Prince 
Edward Island, 1968. 47p. 

35. Fundamentals of good plaster 
technique. Lachine, Smith & Nephew 
Ltd., 1966. lip. 

36. Guide for assessing nursing services 
in long term care facilities. New York, 
National League for Nursing, cl968. 24p. 

37. Guidelines for cyclical scheduling 
by John P. Howell. Ann Arbor, Com- 
munity Systems Foundation, 1965. 12p. 

38. The implementation of a hospital 
occupational health service by the Royal 
College of Nursing and National Council 
of Nurses of the United Kingdom, Lon- 
don, Royal College of Nursing, 1968. 
14p. 

39. Occupational health for hospital 
staff. Excerpts from the papers read 
before the Health Congress of the Royal 
Society of Health at Eastbourne, 29 April 
to 3 May 1968 London, 1968. 5p. 

40. Operation retrieval; list of phy- 
sicians and biomedical scientists training 
or working abroad and available for em- 
ployment in Canada, 1968. Ottawa, As- 
sociation of Canadian Medical Colleges, 
1968. lip. 

4\. A position paper on nursing in 
Manitoba. Winnipeg, Manitoba Associa- 
tion of Registered Nurses, 1968. 17p. 

42. Progress report, first, March 1966. 
London, The Commonwealth Foun- 
dation, 1967. 24p. 



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44 THE CANADIAN NURSE 



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MARCH 1969 



accession list 



48. 



Occupational Research 



(Continued from page 44) 



43. Public health nursing officers and 
administration. Excerpt from papers read 
by Yvette E. Buckoke before the Health 
Congress of the Royal Society of Health 
at Eastbourne, 29 April to 3 May 1968. 
London, 1968. 4p. 

44. Reports presented during the 
forty-eighth annual meeting. Montreal. 
October 31, November 1, 1968. Montreal 
Association of Nurses of the Province of 
Quebec, 1968. 22p. 

45. La responsabilite civile, medicale 
et hospitaliere; evolution recente du droit 
quebecois; par Paul A. Crepeau. Montreal, 
Editions Intermonde, 1968. 38p. 

COVhRNMENT DOCUMENTS 

Canada 

46. Bureau of Statistics. Hospital sta- 
tistics: hospital beds, 1966. Ottawa, 
Queen's Printer, 1968. 94p. 

47. Dept. of Manpower and Im- 
migration. Operation retrieval; Canadian 
University Service Overseas (CUSO) re- 
turning volunteers who will be available 
for employment in Canada, 1968-69. 
Ottawa, 1968.lv. 



Section. Career information publications. 
Ottawa, Queen's Printer, 1968. 2v. 

49. Dept. of National Health and 
Welfare. Research projects, 1968-69. 
(Research under the National Health 
Grants). Ottawa, 1968. Iv.R 

50. . Research under the 

National Health Grants; general in- 
structions. Ottawa, 1968. 19p. 

51. . Research and Statistics 

Directorate. Social security in Canada. 
Ottawa, 1968. 165p. 

52. Medical Research Council of Can- 
ada. Reference list of medical research 
projects in Canada 1968-69. Ottawa, 
Medical Research Council, 1968. 276p. R 

53. National Research Council of 
Canada. NRC Review, 1968. Ottawa, 
Queen's Printer, 1968. 237p. 

54. Parliament. Senate. Special Com- 
mittee on Science Policy. Proceedings; 
phase 1, 2d session of the 27th Parlia- 
ment, 1967-1968. Ottawa, Queen's 
Printer, 1968. 328p. 

U.S.A. 

55. Dept. of the Army. Improve your 
writing. Washington, 1959. 28p. 

56. Dept. of Health, Education and 
Welfare. Getting your ideas across 
through writing. Washington, U.S. Gov't. 
Print. Off., 1950. 44p. 

57. . Public Health Service. 

List of journals indexed in Index 
Medicus, National Library of Medicine. 



Washington, U.S. Gov't. Print. Off.. 1968. 
97p. 

58. Environmental Radiation Ex- 
posure Committee. Report on environ- 
mental contamination bv radioactive 
substances, Dec. 1, 1967. Rolleville. Md., 
National Center for Radiological Health. 
1968. 24p. 

59. National Center for Health Sta- 
tistics. Design and methodology for a 
national survey of nursing homes. Wash- 
ington, U.S. Dept. of Health, Education 
and Welfare, 1968. 37p. 

STUDIES DEPOSITED IN 

CNA REPOSITORY COLLECTION 

60. An exploratory study of the pro- 
fessionalization of registered nurses in 
Ontario and the implications for the 
support of change in basic nursing edu- 
cational programs, by Dorothy Jean 
Kergin. Ann Arbor, Mich., 1968. 244p. 
Thesis — Michigan. R 

61. Rapport du projet de recherche 
no. 1, par M.L. Gingras. Toronto, Conseil 
Canadien d'accreditation des hopitaux, 
1968. 148p. R 

62. The use of a conceptual model to 
evaluate psychiatric nursing therapy by 
Dorothy May Pringle. Denver, Col., i968. 
89p. Thesis (M.Sc.N.) - Colorado. R 

63. A view from the top of the hill; 
decentralization of a state hospital by 
Beatrice Biron. Brainerd, Minn.. 1968. 

56p.R n 



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MARCH 1969 



THE CANADIAN NURSE 45 



classified advertisements 



ALBERTA 



ALBERTA 



BRITISH COLUMBIA 



Opportunity for team teaching in nursing in o Junior 
College setting. INSTRUCTORS (3) to be appointed in 
1969 - - one with Psychiatric Nursing preparation; 
ond one with Pediatric or Maternal Child preporo- 
tion; and one other with either preparation. Qualif.- 
cation is Master's degree in clinical specialty pre- 
ferred. Bachelor's degree accepted for temporary 
oppointment. Active and auxiliary hospital proviides 
clinical experiences. Total student enrollment of 70. 
Total staff of seven for nursing. Apply for further "*' 
details to; Director, Department of Nursing Educo-*' 
tion. Red Deer Junior College, Red Deer, Alberta. 

REGISTERED NURSES FOR GENERAL DUTY in a 3d- 

bed hospital. Salary 1968 $405-$485. Experienced 
recognized. Residence available. For particulars con- 
tact: Director of Nursing Service, Whitecourt General 
Hospital, Whitecourt, Alberta. Phone: 778-2235. 

GENERAL DUTY NURSES (2) for a 21-bed hospital 
in Northern Alberto. Separate Nurses' residence. 
Uniforms laundered. Salary presently $420 to $490 
per month pending 1969 negotiations. Apply to: Mrs. 
Evelyn Forbes, Administrator, Berwyn Municipal 
Hospital, Berwyn, Alberta. 

General Duty Nurses for ccrive, accredited, well- 
equipped 65-bed hospital in growing town, popula- 
tion 3,500. Salaries range from S405 — S485 ccm- 
mensL'rate with experience, other benefits. Nurses' re- 
sidence. Excellent personnel policies and working 
conditions. New modern wing opened in 1967. Good 
communications to large nearby cities. Apply: Di- 
rector of Nursing, Erooks General Hospital, Brooks, 
Alberto. 

GENERAL DUTY NURSES (2) for small modern Hos- 
pital on Highway No. 12. East Central Alberto, 
Salary range $430 to $510 including Regional 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$11.50 for 6 lines or less 
$2.25 for each additional tine 

Rates for display 
advertisements on request 

Closing date for copy and cancellation Is 
6 weeks prior to 1st day of publication 
month. 

The Canadian Nurses' Association does 
not review the personnel policies of 
the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses' Association of the 
Province in which they are interested 
in working. 



Address correspondence to: 

The 

Canadian 
Nurse 

50 THE DRIVEWAY 
OTTAWA 4. ONTARIO. 




Differential. Residence available. Personnel policies 
as per AARN and A.M. A Apply: Director of Nursing, 
Coronation Municipal Hospital, Coronation, Alberto. 



GENERAL DUTY NURSES for 94-bed General Hos 
pital located in Alberta's unique Badlands. $405 
$485 per month, approved AARN and AHA per- 
sonnel policies. Apply to: Miss M. Howkes, Direcio 
of Nursing, Drumheller General Hospital, Drumhel 
ler, AlberlG. 1-31-2A 



Gvnaral Duty Nursas for 64-bed active treatrr^eni 
hospital, 35 miles south of Calgary. Salary range 
$405 - $485. Living accommodation available in sep- 
arate residence if desired. Full maintenance in 
residence $50.00 per month Excellent Personnel 
Policies and working conditions. Please apply to: 
The Director of Nursing, High River General Hos- 
pital, High River, Alberto. J-46-1A 



GENERAL DUTY NURSES for 200-bed active treatment 
hospital. Credit for past experience and postgrad- 
LOte training. Employer-employee porticipation in 
medicol coverage and superonnuoton. Apply: D rec- 
tor of Nursing Service, St. Michael's General Hos- 
pital, Lethbridge, Alberta. 



General Duty Nurses required by 150-bed general 

hcsoital presently expanding to 230 beds. Salary 
1967, S380 to $450; 1968 — S405 to $485. Experi- 
ence recognized. Residence available. For particulars 
contact Director of Nursing Service, Red Desr 
Generol Hospital, Red Deer, Aibertc. 



Ganeral Duty Nursing positions are available in c 

100-bed convalescent rehabilitation unit forming 
part of a 330-bed hospital complex. Residence 
available. Salary 1 967 — $380 to $450. per mo. 
1968 — $405 to $485. Experience recognized. For 
full particulars contact Director of Nursing Service, 
Auxiliary Hospital, Red Deer, Alberta. 



BRITISH COLUMBIA 



OPERATING ROOM ASSISTANT SUPERVISOR required 
with preparation and experience, must be eligible 
for B.C. Registration. For further information apply 
to: Director of Nursing, Royal Jubilee Hospital, 
Victoria, British Columbia. 



OPERATING ROOM INSTRUCTOR w/ith University 
preparotion, for a 450-bed hospital with a school of 
nursing, 145 students. Apply: Associate Director, 
School of Nursing, St. Joseph's Hospital School of 
Nursing, Victoria, British Columbia. 



COME TO PACIFIC NORTHWEST — Gateway to 
Alaska, Friendly community, enjoyable Nurses' Resi- 
dence accommodation at minimal cost. RNABC con- 
tract in effect. Salories — Registered $508 to $633, 
Non-Registered $483, Northern differential $15 a 
month. Travel allowance up to $60. refundable 
after 1 2 months service. Apply to: Director of 
Nursing, Prince Rupert General Hospital, 551-5th 
Avenue East, Prince Rupert, British Columbia. 



B.C. R.N. for General Duty in 32 bed General Hospi- 
tal. RNABC 1969 salary rate $508 - $633 and fringe 
benefits, modern, comfortable, nurses' residence in 
attractive community close to Vancouver, B.C. For 
applicaion form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. 2, Hope, B.C. 2-30-1 



Generol Duty Nurses for active 30-bed hospital. 
RNABC policies and schedules in effect, also North- 
ern allowance. Accommodations availoble in res- 
idence. Apply: Director of Nursing, General Hospital, 
Fort Nelson, British Columbia. 2-23-1 



GENERAL DUTY NURSES (two). Fully accredited 25- 
bed hospital Rogers Pass Area Trans Canada High- 
way. Comfortable Nurses' Residence. RNABC Agree- 
ment in effect. 3 months allowed to gain B C. Regis- 
tration. Apply: Mrs. E. Neville, R.N., Director of 
Nursing, Golden & District General Hospital, P.O. 
Box 1260, Golden, B.C. 



General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in occordonce with RNABC. Com- 
fortable Nurses' home. Apply: Director of Nursing, 
Boundary Hospitol, Grand Forks, British Columbia. 

GENERAL DUTY NURSES for 63-bed active hospital 
in beautiful Bulkley Valley. Booting, fishing, skiing, 
etc. Nurses' residence. Salary $466. -$490., main- 
tenance $70., recognition for experience. Apply: 
Director of Nursing, Bulkley Valley District Hospital, 
Smithers, British Columbia. 

General Duty Nurse for 54-bed active hospital in 
norttiwestern B.C. Salaries: B.C. Registered $405, B.C. 
Non-Registered, $390, RNABC personnel policies 
in effect. Planned rotation. New residence, room and 
board: S55/m. T.V. and good social activities. 
Write: Director of Nursing, Box 1297, Terrace, British 
Columbia. 2-70-2 

GENERAL DUTY AND PRACTICAL NURSE needed for 
70-bed General Hospital on Pacific Coast 200 miles 
from Vancouver. RNABC contract, $25. room and 
board, friendly community. Apply: Director of Nurs- 
ing, St. George's Hospital, Alert Bay, British Colum- 
bia. 

GENERAL DUTY, OPERATING ROOM AND EXPERI- 
ENCED OBSTETRICAL NURSES for 434-bed hospital 
with school of nursing. Salary: $508-$633, these 
rates are effective January 1969, plus shift differ- 
ential. Credit for post experience and postgraduate 
training. 40-hr. wk. Statutory holidays. Annual incre- 
ments; cumulative sick leave; pension plan; 20 
working days annual vacation; B.C. registration re- 
quired. Apply; Director of Nursing, Royal Columbian 
Hospital, New Westminster, British Columbia. 

GRADUATE NURSES for 24-bed hospital, 35-mI. from 
Vancouver, on coast, salary and personnel prac- 
tices in accord with RNABC. Accommodation availa- 
ble. Apply: Director of Nursing, General Hospital, 
Squcmish, British Columbia. 2-68-1 

GRADUATE NURSES FOR GENERAL DUTY (urgently 
needed) in United Church frontier hospitals in 
Western Canada and Newfoundland. This Is good 
experience in all phases of general nursing. Room 
and board supplied in staff residence ot nominal 
cost; salary and working conditions as in agree- 
ment with Reg. Nurses' Assoc, of the province con- 
cerned. Please contact: W. Donald Wott, M.D., 
Superintendent of hospitals, 6762 Cypress Street, 
Vancouver 14, B.C. 



MANITOBA 



GENERAL DUTY REGISTERED NURSES for 36-bed hos- 
pital. Starting salary $460 per month with an addi- 
tional basic raise of $10 Sept. 1st. For particulars 
and personnel policies contoct: Director of Nurses, 
Sour is District Hospitol, Souris, Manitoba. 



NOVA SCOTIA 



GENERAL DUTY NURSES: Positions available for 
Registered Qualified General Duty Nurses for 138- 
bed active treatment hospital. Residence accom- 
modotion available. Applications and enquiries will 
be received by: Director of Nursing, Blanchard-Fraser- : 
Memorial Hospital, Kentvllle, Nova Scotia. 6-19-1' 



ONTARIO 



46 THE CANADIAN NURSE 



DIRECTOR OF NURSING required for District Health 
Unit. Good personnel policies. Apply to: Dr. A.E. 
Thorns, Medical Officer of Health, 70 Charles St., 
Brockville, Ontario. 

SENIOR SUPERVISOR PUBLIC HEALTH NURSING — 

Required to direct nursing services in Genera I izerJ 
Public Heolth program. Salary to be negotioted. 
Employer shared OMERS, O.H.S.C. and Windsor 
Medical. One month vacation. Cumulative sick leave. 
Liberal car allowance. APPLY: stating qualifications 
and experience to: E.G. Brown, M.O.H. and Director, 

MARCH 1969 



April 1969 



The 






OO ^Ic VV^ 



•^ ^ •: ^t> 



Canadian 
Nurse 





medicolegal problems 
in the coronary care unit 



and now... 
your income tax 



nursing assistants 
are here to stay 






-.V 



^ I 



\ 



"e^ 




o 



/ 




SOME STYLES ALSO AVAILABLE IN COLORS ... SOME STYLES 3'/2-12 AAAA-E, S17.95 to %2i. 95 Slightly Higher Denver West 
For a complimentary pair of white shoelaces, folder showing all the smart Clinic styles, and list of stores selling them, write: 

THE CLINIC SHOEMAKERS • Dept. CN-4 1221 Locust St. • St. Louis, Mo. 63103 



GOIMimilllN ID OIHESS 




Only two months to go to the 
INTERNATIONAL COUNCIL OF NURSES' 
14th OUADRENNIAL CONGRESS 

Place Bonaventure, Montreal, Canada, 
22 to 28 June, 1969. 



PROGRAM HIGHLIGHTS: 

Sunday, 22 June 

3.00 p.m. Interfaith Service 

8.00 p.m. Opening Ceremony 



Monday and Tuesday, 23 and 24 June 
Open meeting of Council of National 
Representatives (CNR) 

Wednesday, 25 June 
"Focus on the Future" 
a.m. Plenary session — 

Forecasting the Future 
p.m. Plenary session — 

Implications of Change 

Thursday, 26 June 

"Focus on the Future" 

a.m. Plenary session — 

Education for Today and To- 
morrow. Basic Programs 

p.m. Plenary session — 

Education for Today and To- 



morrow. Post Basic and Post- 
graduate Programs 

5.00 p.m. Voting for ICN Officers by 
CNR 

8.00 p.m. Students' Congress 



Friday, 27 June 
"Focus on the Future" 
a.m. Plenary session — 

Security for Tomorrow 
p.m. Plenary session — 

Leadership in Action 
8.00 p.m. Closing Ceremony 

Admission of new member 
associations to ICN 
New ICN Officers 
announced 

Saturday, 28 June 
Canada Hospitality Day. 



N.B. 



Special Interest Sessions — 19 topics in English and French, will be 
running Monday through Friday 

International Nursing Exhibition — runs Monday through Wednesday 



FOR FURTHER IN FORMA T/ON, INCL UDING R EG 1ST R A TION 
KITS, PLEASE WRITE TO: 

ICN Congress Registration, 

50, The Driveway, 

Ottawa 4, Ontario. 



N. B. —Daily registration fee at Congress now $10.00 



APRIL 1%9 



THE CANADIAN NURSE 1 



ELI LILLY AND COMPANY (CANADA) LIMITED, TORONTO, ONTARIO 



For four fenerations 
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♦iDENTicoDE'" (formula identification code, Lilly) provides quick, positive product identification. 



The 

Canadian 
Nurse 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses' Association 



Volume 65, Number 4 




^^^ 



April 1%9 



33 Nursing Assistants Are Here to Stay D.J. Kergin 

34 And Now Your Income Tax F.S. Mallett 

37 Medicolegal Problems Can Arise in the 

Coronary Care Unit G.G. Crotin 

40 Smoking Habits of Canadian Nurses and Teachers A.J.Phillips 

42 Hemodialysis in the Home S. Wood 

45 Idea Exchange 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses' Association. 



4 Letters 

7 News 

22 Names 

24 Dates 



28 New Products 

30 In a Capsule 

46 Books 

50 Accession List 



Executive Director: Helen K. iMussallem • 
Editor: Virginia A. Lindaburv • Assistant 
Editor: Eleanor B. Mitchell • Editorial Assist- 
ant: Carol A. KoUarsky • Circulation Man- 
ager: Ber>l Darling • Advertising Manager: 
Ruth H. Baumel • Subscription Rales: Can- 
ada: One Year, S4.50; two years, $8.00. 
Foreign: One Year, S5.00; two years, $9.00. 
Single copies: 50 cents each. Make cheques 
or money orders payable to the Canadian 
Nurses' Association. • Change of Address: 
Four weeks' notice; the old address as well 
as the new are necessary, together with regis- 
tration number in a provincial nurses' asso- 
ciation, VNhere applicable. Not responsible for 
journals lost in mail due to errors in address. 
® Canadian Nurses' Association 1969. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in India ink on vvhite paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
.Authorized as Second-Class Mail by the Post 
Office Department, Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4, Ontario. 



PRIL 1969 



Editorial 



The strike of 18 nurse educators employed 
by the Hamilton and District School 
of Nursing (News, page 7) will probably be 
ended and the main issues settled — in one 
way or another — by the time this editorial 
is read. Even so, we believe that certain 
aspects of this strike and the negotiations 
that preceded it need to be examined, 
because they have implications for all nurses. 

Let it be understood that we support 
these nurse educators in their efforts to 
obtain fair wages, benefits, and working 
conditions. We are convinced that they 
had no other alternative but to take the 
action they did. They went on strike as a 
last resort, after they had met again and 
again with an employer who remained 
inflexible. 

The experiences of these teachers raise 
several questions. First, how can 
collective bargaining be considered 
anything but a farce, when an agency such 
as the Ontario Hospital Services 
Commission — a government commission 
that is responsible to the minister of 
health — is in a position to pull strings so 
effectively that employers of nurses and 
nurse educators refuse to budge an inch 
from the salary directives it lays down? 

Second, why, in this instance, does 
the employer say "We cannot meet 
their demands," and yet offer to 
submit the grievances to a government- 
appointed arbitrator, whose findings would 
be binding on both parties? The 
arbitrator might well recommend that the 
teachers be paid the salaries they are 
asking; it is even conceivable that he 
would recommend higher salaries than they 
are demanding. 

This offer on the part of management 
is difficult to fathom. It gives the 
impression that the arbitrator — who is 
supposed to be impartial — might see 
things their way. 

Our third question is this: Why did 
2 of the 18 instructors, one of whom 
definitely voted in favor of strike 
action, become turncoats and return 
to work? If they didn't favor strike 
action, they should have voted against it; 
having declared their intention, 
they should not have abandoned their 
colleagues and their principles. 

Our fourth question concerns the 
nursing students who, as future members 
of the profession and as future 
employees, may one day be faced with 
similar grievances. According to a 
Globe and Mail report, the students 
"took no side in the dispute," although 
"many students were friendly to the 
strikers." 

We understand the concerns of these 
students who wish to see an immediate 
settlement. Is it not possible, however, 
that the students' support of their 
instructors might hasten this settlement? 
And is it not possible that the profession 
might progress further — in every way 
— if more of its members and future 
members were willing to take a stand 
on an issue, instead of remaining 
neutral? — V.A.I. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters will be considered for publication, but 

name will be withheld at the writer's request. 



Brighter lives for the old 

It isn't too many years ago that 
geriatric care was carried out in "asy- 
lums" where patients were treated as 
incurable and hopeless. Many of these 
institutions were called Hospitals for 
Incurables. 

Today, old people are no longer for- 
gotten and neglected in old folks' homes. 
The attitude of the general public has 
changed and so has that of nurses. No 
longer are old people considered to be a 
chore, their care uninteresting and boring. 
Thanks to our enterprising and thought- 
ful nursing leaders, geriatric treatment has 
become known as "extended care"; here, 
good nursing programs work wonders for 
our aged ones who otherwise might have 
become a real burden. 

This improved attitude to the old has 
led to the rehabilitation of paraplegics, 
many leading useful and busy lives from 
their wheelchairs. Cars are designed 
especially for them, and ramps are built 
for their convenience in hospitals or in 
their own homes. Physiotherapy and 
hydrotherapy is put into practice in 
swimming pools especially designed for 
easy entrance. 

This type of work takes dedication on 
the part of the nurses involved. It can 
become tedious and very uninteresting 
unless the nurse takes a sincere interest in 
each patient as an individual with indi- 
vidual needs. The care of these people can 
prove rewarding when even a little 
progress is made by a seemingly helpless 
person after many exercises and attempts, 
perhaps over a long period of time. 

In this field, "room number so and so" 
or "case number such and such" must be 
put aside and nurses must try to treat the 
patient as an individual personality with 
specific needs entirely his own. - Isobel 
Simpson, Prince Rupert, B.C. 

The unsigned letter 

The letter in the November 1968 issue 
entitled "A paid president? ", signed 
"B.C. Nurse", annoyed me. In their vis-a- 
vis in the August 1968 issue, Mary 
Richmond and Monica Angus had the 
courage to present their opposing points 
of view on the issue of a paid president 
for our consideration. Surely we must 
have the courage to identify ourselves 
with issues we feel strongly about, if we 
are going to make progress in our pro- 
fessional association. 

The unsigned letter, the mumbing in 
the back row at chapter or provincial 
Registered Nurses' Association meetings, 

4 THE CANADIAN NURSE 



the beefing at coffee break, may meet the 
needs of the individual but they certainly 
do not meet the needs of the group. I 
realize that the explanation for these 
kinds of activities is embedded in our 
tradition, but Mary Richmond and 
Monica Angus have made a breakthrough. 
Let's not slip back. — Patricia M. Wads- 
worth, Vancouver. 

Books needed overseas 

I am writing to you with regard to a 
problem faced by the Canadian Council 
for International Co-operation, in its pro- 
gram of sending educational books to 
schools, libraries and training centers in 
developing countries. 

Several months ago, we received an 
urgent appeal from the Nirmala Hospital 
in Calicut (Kerala), India, for books on 
nursing science and practice and nursing 
journals for its training program. As our 
book centers have not received such 
books or journals for some time, we have 
been unable to meet this request. 

We would appreciate any donations of 
such material, which can be sent to: the 
Overseas Book Centre, 207 Queen's Quay 
West, Toronto 1, Ont.; the Overseas Book 
Center, 4130 Verdun Ave., Montreal 19, 
Que.; or the Canadian Council for Inter- 
national Co-operation, 75 Sparks St., 
Ottawa 4, Canada. Anyone in another 
part of the country wishing to help could 
write to Ottawa for instructions on where 
to send the books. 

We will undertake the cost of sending 
the books to the Nirmala hospital. If we 
receive more books than this hospital can 
use, we will have them sent to similar 
deserving institutions. - W.A. Teager, 
Ottawa. 

Ostomy rehab — a necessity 

In May 1962, after having had ulcer- 
ative colitis for five years, I underwent 
surgery that left me with a transverse 
colostomy. On my surgeon's instructions, 
a nurse attempted to teach me to irrigate; 
we thought we were following the in- 
structions on the box, but did everything 
wrong. How easy it would have been to 
become discouraged; instead, as I recuper- 
ated, I became determined to become a 
self-taught enterostomal therapist dedi- 
cated to the idea that patients undergoing 
this surgery should have the support and 
guidance of a fellow 'ostomist. 

My qualifications include an RN 
degree, extensive reading throughout my 
five-year illness, and the best teacher of 



all — living, coping, accepting. I was 
determined to convince the hospitals and 
doctors concerned that I was capable of 
offering a new service, not duplicating 
anything being done for 'ostomy patients. 

I approached four surgeons in Victo- 
ria. They seemed interested in using the 
service I offered: a complete counseling 
service for 'ostomy patients and their 
families, preoperative care, postoperative 
care, fitting of apphances, and teaching of 
irrigation — in short, anything needed to 
accustom a patient to hfe with an 
'ostomy. 

It is four years since 1 was called to see 
my first patient — a frightened young 
woman facing an ileostomy after years of 
ulcerative colitis. I have just finished 
teaching irrigation procedure to my 67th 
patient — an elderly man fully accepting a 
colostomy. I have a good working re- 
lationship with most Victoria surgeons 
and full acceptance in the hospitals and 
with the local surgical supply house. My 
satisfaction comes from seeing frightened, 
depressed patients become cheerful, 
accepting people. 

As I enter my fifth year of 'ostomy 
rehabilitation, 1 hope to expand the 
services I can offer to include more 
lecturing and teaching to hospital staff as 
well as the individual instruction of 
patients. There is a real need for stomal 
therapists and visiting members from 
'ostomy clubs. Happy, accepting patients 
are a hving testimonial to the necessity to 
continue this work. - Aileen E. Barer, 
R.N., Stomal Therapist, Victoria, B.C. 

Uniforms create invisible barriers 

I was interested in the letter entitled 
"Caps and uniforms - proud insignia" in 
the December 1968 issue. Perhaps the 
main reason that nursing is giving up its 
uniform and cap is that nurse-patient 
relationships are improved when nurses 
wear civies. This has been proven on psy- 
chiatric wards in the United States and 
Canada and it is being proven on general 
wards in various areas; Winnipeg's Victoria 
General Hospital is one example. As for 
"proud insignia," I believe that the school 
pin outranks the school cap! 

Some nurses do look "handsome" and 
"imposing" in their white uniforms. 
However, there is no reason why the 
nurse cannot carry herself with pride and 
dignity minus a cap and in a dress of 
another color; she need not look "ordi- 
nary" or "dowdy" in civies. 

Many nurses hide behind their uni- 

(Continued on page 6) 

APRIL 1%9 



Elastoplast 

Anchor 
Dressing 

For wounds in 
awkward places 




Shaped to resemble the letter "H", these sterile 
elastic dressings are ideal for dressing knuckles, 
heels, toes and other hard-to-bandage places. 

Elastoplast Anchor Dressings expand and contract 
with every movement of joint or body. The adhe- 
sive is porous to promote natural healing. 

Cartons of 100 dressings, 3" x I'/a", individually 
wrapped and sterilized. 

For further information write to: 

.'StN'. ^'"'^'^ ^ Nephew Limited, 2100 - 52nd Avenue, 
\ ,/' Lachine 620, P.Q., Canada. 



Whenyourddy 






starts at 

6 a.m... you re on 
chargeduty... 
you've skimped 
onmeals...^ 
and on sleep..] 
you haven't had^ 
time to hem 
a dress... ^ 
make an apple pie... 
wash your hair... 
even powder ^/M 
your nose 
in comfort."^ 

it's time lor a change. Irregular hours and meals on-lhe- 
run won't last. But your personal irregularity is another 
matter. It may settle down. Or it may need gentle help 
from DOXIDAN. 

use 

DOXIDAN" 

most nurses do 






DOXIDAN Is an effective laxative for the gentle relief of 
constipation without cramping. Because DOXIDAN con- 
tains a dependable fecal softener and a mild peristaltic 
stimulant, evacuation is easy and comfortable. 

For detailed information consult Vademecum 
or Compendium. 

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I PMAC I 

6 THE CANADIAN NURSE 



(Continued from page 4) 

forms, believing that they are more 
authoritative when wearing them. So be 
it. But let's think of patients oriented 
over the years not to argue with or 
question that figure in white, but to do 
what she says. In some hospital wards the 
patient is relegated to the status of a child 
unable to think for himself at all. 

Public health nurses who, in Winnipeg 
at least, wear civies, meet the patient in 
his environment on an equal footing and 
as a friend. In my experience with public 
health nurses, I saw nothing that detract- 
ed from their knowledge, ability, bearing, 
or acceptance by patients because they 
wore civies. 

Take the hospital nurse out of uni- 
form, put her in a washable dress, and an 
invisible barrier is removed. Authority 
remains but friendship develops. 

Let us put and keep our patients first. 
Our image will not be tarnished by what 
we wear. - Bonnie Kerr, Reg.N., 1968 
graduate, Victoria General Hospital, 
Winnipeg. 



December issue 

I congratulate the circulation manager 
and the editors on the very nice format of 
the December 1 968 issue. 

As a librarian, it is very satisfying to 
me to see The Canadian Nurse join the 
group of journals publishing their yearly 
index in the December issue. Journals 
that do not follow this procedure cause 
librarians more headaches than enough, 
because we must wait so long for the 
index before we can have the journal 
bound. Congratulations! -Pauline Cum- 
mer, Librarian, Misericordia Hospital 
School of Nursing, Bronx, New York. 



Prices compare favorably 

1 wish to commend the wide and 
excellent coverage given in the January 
1969 issue of The Canadian Nurse to the 
Registered Nurses' Association of Onta- 
rio's Regional Conference on the Use of 
Audio-Visual Aids in Nursing held in 
Toronto from November 11-14, 1968. 

However, in the interest of nurses who 
may attend future RNAO conferences, 
and possibly at the same hotel, may I 
correct the impression of an excessive 
price range as stated on page 24, and state 
that we have always experienced ex- 
cellent service and quality, and that prices 
compare favorably with other hotels of a 
similar class across the province. 

With the current cafeteria and dining 
room menus as my reference, I found 
that meals described in the article were 
being offered at approximately 40-50 



percent less than prices quoted on page 
24. Also, two city bus stops to the center 
of Toronto are within 75 yards of the 
main entrance, with service every 20 
minutes. - Eleanor Trutwin, Secretary, 
Planning Committee, RNAO, Toronto. 

Nursing scholarships 

The Regina General Hospital School of 
Nursing Alumnae makes available a 
scholarship of five hundred dollars ( $500) 
to active members of the Alumnae who 
are presently engaged in nursing. This 
scholarship may be used in any university 
school of nursing for post-graduate study. 
Completed applications must be received 
by June 1, 1969. 

Application forms and further in- 
formation may be obtained from: (Mrs.) 
Nora M. Kitchen, Chairman, Scholarship 
Committee, Suite 301, 2536 Parliament 
Avenue, Regina, Saskatchewan. 

The Royal Canadian Army Medical 
Corps Fund announces an annual bursary 
of $300.00 for dependants of: (a) non- 
commissioned members of the RCAMC, 
Canadian Forces, who have been accepted 
for career status; (b) non-commissioned 
members or former members of the 
RCAMC, Canadian Forces, or CA(R), 
who have served a minimum of five years 
subsequent to 1950; (c) former RCAMC 
non-commissioned members of the 
CASF(Korea). 

The bursary is an award to a de- 
pendent who has achieved satisfactory 
scholastic standing in the entrance, first, 
second or third year of a recognized 
Canadian university, teachers' college, 
school of nursing, or institute of technol- 
ogy course requiring a minimum of 2400 
hours of instruction. 

Further details may be obtained from 
the Secretaiy, RCAMC Bursary, Surgeon 
General Staff, Canadian Forces Head- 
quarters, Ottawa 4, Ontario. - Lt. G.H. 
Rice, Secretary, RCAMC Bursary. 

Alumnae wish to correspond 

Members of the Alumnae Association 
School of Nursing, Jewish General Hospi 
tal, Montreal, are interested in corres- 
ponding with other nursing alumnae 
groups to exchange program ideas and 
projects. 

Please write to: The Alumnae Associa- 
tion, Jewish General Hospital School of 
Nursing, 3755 Cote Ste-Catherine Road, 
Montreal. - Eileen Shalit, Montreal. 



Journal needed 

We are trying to find a copy of the 
February 1962 issue of Nursing Outlook. 
If any of The Canadian Nurse readers can 
supply this issue, please write to: Mrs, 
P.A. Whitaker, School Librarian, Royal 
Victoria Regional School of Nursing, 61 
Wellington St.W., Barrie, Ontario. C 

APRIL 1969 



news 



Nurse Educators Go On Strike P^ 

Hamilton. -Members of the faculty of 
the Hamilton and District School of ~--^ 
Nursing, with the exception of the direc- 
tor and assistant director, went on strike 
March 4 when they were unable to reach 
agreement with their employer. 

The strike followed 1 1 months of 
unsuccessful negotiations with the em- 
ployer. The 18 instructors, organized as 
the Nurses' Association Hamilton and 
District School of Nursing and certified as 
a collective bargaining unit by the Labour 
Relations Board on February 12, 1968, 
had met three times with management 
before asking the provincial minister of 
labor to appoint a concihation officer last 
July. When the conciliation officer's 
attempts to effect a settlement were 
unsuccessful, a conciliation board was 
appointed in November. This board met 
with the two parties in January, but did 
not submit any recommendations to the 
minister of labor, apparently because 
the two parties were so far apart in their 
demands. 



Areas of Disagreement 

The chief areas of disagreement are: 
transportation expenses, educational 
leave, benefit plans, hours of work, work 
load, and salaries. 

The Nurses' Association is asking for a 
flat rate of S15 per week to cover travel 
expenses and/or travel time involved, 
since teachers travel to the five outlying 
hospitals, where students receive their 
clinical experience, three or four days a 
week. Management has offered a cash 
allowance of three dollars a day "when 
no other transportation is available": the 
Nurses' Association points out, however, 
that '"available" often means taking a bus 
as early as 6: 15 a.m. and arriving one and 
one-half to two hours before their start- 
ing time. No compensation for this incon- 
venience and loss of time is provided. 

The Nurses' Association has also- re- 
quested a maximum of 16 hours a week 
of teaching and a minimum of 16 hours a 
week for lecture preparation, with at least 
three hours required for other duties. The 
school board agreed to a 38 1/2 hour 
week, but made no concession for over- 
time work. Overwork is apparently a vital 
issue in the present impasse. 

Salary demands by the teachers are 
related to the academic qualifications 
required by the school (Reg.N. with a 
university degree); the actual qualifica- 
tions held by the present staff (all staff 
are registered nurses - some have a 
APRIL 1%9 




bachelor's degree, others have- a master's 
degree); and current rates for teachers in 
secondary schools or colleges requiring 
equivalent education (for example, the 
1 9 68 salary range for instructors in 
Teachers' Colleges in the province was 
$11,218 to 513,279). 

The Nurses' Association is asking for a 
minimum of S8,200 and a maximum of 
512,400, achieved by 7 increments of 
5600 for teachers with a baccalaureate 
degree; and a minimum of 510,200 and a 
maximum of 514,400, with the same 
increments, for teachers with a master's 
degree. Management has offered 57,632 
- 58,950 for teachers with a bachelor's 
degree, achieved by 5 annual increments 
of 5264; and 58,112 - 59,432. with the 
same increments, for teachers with a 
master's degree. 

Areas of Frustration 

The 18 instructors list four areas of 
frustration in their negotiations: 
• The employer's refusal to equate the 
instructors with other educators when 
deciding on salary and other benefits; 



• The employer's refusal to bargain "in 
good faith," and the delaying tactics used 
since the instructors were certified as a 
collective bargaining unit. 

• The impossibility of bargaining with 
"the ghost of the Ontario Hospital Servi- 
ces Commission," which has set wage 
scales for nurses in the province, but is 
not represented at the conciliation hear- 
ings. 

• The suggestion by a management 
representative that the jobs of the nurse 
educators were more similar to instruc- 
tors of welding apprentices than to secon- 
dary school teachers. 

In a telephone interview with The 
Canadian Nurse, Jack Lowes, personnel 
director for the Hamilton and District 
School of Nursing, stated that salaries are 
the main stumbling block as far as mana- 
gement is concerned. "We just can't meet 
their salary demands," Mr. Lowes said. 
When asked to comment on the teachers' 
complaint that it is impossible to bargain 
with the ghost of OHSC, Mr. Lowes said 
"No comment." He did say, however, 
that the School cannot "get out of line 
THE CANADIAN NURSE 7 




with what other nurse educators are being 
paid." 

Mr. Lowes said that management refu- 
ses to equate the nurse educators' salaries 
with those paid to other educators, 
because "they [the nurse educators] are 
nurses, and are certified as nurses by the 
department of labor." He added that the 
nurse educators are really clinical instruc- 
tors, and that they receive salaries com- 
parable to those paid to other clinical 
instructors in the province. 

Commenting on Mr. Lowes' statement, 
Anne Gribben, director of employment 
relations at the Registered Nurses' Asso- 
ciation of Ontario, said: "We have two 
arguments against Mr. Lowes' reasoning. 
First, although these nurse educators are, 
indeed, certified as a Nurses' Association, 
they are required by management to 
have at least a bachelor's degree. Second, 
these nurse educators are more than 
'clinical instructors.' They teach in the 
classroom, as well as in the clinical area, 
and are responsible for the counseling 
program for all students." 

Mr. Lowes said that the School Board 
is doing its best to keep the school open. 
When asked whether there was a danger 
that the College of Nurses of Ontario 
might cease to approve the school becau- 
se of the altered curriculum, Mr. Lowes 
sounded surprised, but admitted that the 
College did have this right. 

He added that management was willing 
to submit the differences to an arbitrator 
appointed by the government. He agreed, 
however, that the teachers had the right 
to strike and did not have to submit to 
compulsory arbitration. According to 
Anne Gribben, the teachers believe they 
would be most unwise to submit their 
grievances to compulsory arbitration. 
"Past experience has shown that arbitra- 
tors do not always look at the facts," she 
said, "and have not awarded on the basis 
of what could have been obtained had the 
party involved had the right to strike." 

The Registered Nurses' Association of 
Ontario, which greylisted the School 
when the instructors went on strike, 
expressed concern for the 156 students 
who are enrolled in the two-year course 
offered by the Hamilton and District 
School, but pointed out that the inflexi- 
bility of the employer leaves the teachers 
with no alternative other than to take 
"the only legal action open to them." 

RNAO has worked closely with the 
instructors, helping them to organize for 
certification and to draw up proposals, 
and appearing with the Nurses' Associa- 
tion's representatives at the bargaining 
table. 

8 THE CANADIAN NURSE 



CNA's 1968-70 Goals Approved 

The goals of the Canadian Nurses' 
Association for the 1968-70 biennium 
were approved by the CNA Board of 
Directors at its meeting February 11-14. 
They will be published shortly as a 
separate document for members. 

The goals call for CNA to: 

1. Prepare and arrange for the 14th 
Quadrennial Congress of the International 
Council of Nurses, Montreal, June 22-28, 
1969, and welcome the nurses of the 
world. 

2. Support and promote the program 
of ICN and other international organi- 
zations concerned with world-wide health, 
education and welfare. 

3. Continue to make representations 
on behalf of Canadian nurses to the 
federal government, its departments and 
commissions in the interests of nursing 
and related national and international 
health services. 

4. Promote continuing improvement in 
communications and cooperation 
between CNA and related national and 
international health services. 

5. Advocate support of the Canadian 
Nurses' Foundation. 

6. Establish a national testing service 
to prepare tests that may be purchased 
and used by the provincial registering 
bodies for the licensing and/or regis- 
tration of nurses. 

7. Study national and provincial 
nurses' association relationships, func- 
tions, membership, fee structure, and 
legislation. 

8. Continue to develop standards for 
nursing service and nursing care in order 
to provide systems for evaluation of 
quality of nursing service and nursing 
education programs. 

9. Continue to work toward the pro- 
vision of systems for improving standards 
of nursing service and nursing education 
programs. 

10. Encourage the development of 
nursing diploma programs in educational 
institutions within the general system of 
education at the post-secondary level. 

1 1. Promote continuing education pro- 
grams, particularly those directed by 
educational institutions, for the two iden- 
tified categories of nurse practitioners. 

12. Reflect the beliefs and policy of 
CNA in a revised statement on the nurse's 
social and economic welfare. 

1 3. Reassess national goals for salaries, 
social welfare and conditions of work for 
nurses graduating from the baccalaureate 
and diploma programs. 

14. Provide consultation services to 
the 10 provincial nurses' associations as 
feasible. 

15. Encourage research in relevant 
areas, especially in clinical nursing prac- 
tice, to improve nursing care. 

16. Promote continuing improvement 
in communications between CNA and its 
individual members and between the 



Association and the Canadian people. 

1 7. Publish material on selected topics 
that will help to meet CNA's goals. 

1 8. Initiate dialogue with allied health 
professions on the proliferation of cate- 
gories of health workers with a view to 
formulating policies in this area. 

Daily Registration Fee 

For ICN Congress Reduced 

Ottawa. —The daily registration fee for 
the XIV Quadrennial Congress of the 
International Council of Nurses, to be 
held June 22-28 in Montreal, has been 
reduced from $ 15 per day to $ 10. 

Daily registration will take place 
Monday June 23 to Friday June 27 only. 
Daily registrants will not receive the kit 
containing the official program, and will 
not be allowed to attend the special 
interest sessions or the opening and clo- 
sing ceremonies. 

Three Nurses Appointed 
To Federal Task Forces 

Ottawa. -IhxQQ nurses are among the 
40 members of seven task forces on 
health costs announced by Health and 
Welfare Minister John Munro in late 
February. 

They are: Louise Miner, president- 
elect, Canadian Nurses' Association, 
appointed to the task force on public 
health services; Margaret McLean, CNA 
second vice-president, task force on sala- 
ries and wages; and Myrna Sherrard, 
Moncton City Hospital, N.B., task force 
on operational efficiency. 

In addition, one task force — on 
methods of delivery of medical care — has 
asked the CNA to present its official 
current views on the future role of the 
nurse in delivery of medical care. Four 
representatives of the association came 
before the task force March 3 for this 
purpose. 

The seven task forces will prepare 
reports for the federal-provincial commit- 
tee on costs of health services. Members 
include federal and provincial representa- 
tives as well as professional persons from 
related health fields. 

Membership in the task forces was 
determined by the secretariat established 
for the national study, following consul- 
tation with task force chairmen, federal 
and provincial' health authorities, and 
related health associations. None of the 
10 chairmen and co-chairmen are nurses. 

The extensive study into health costs 
will cover three major areas: hospital 
services, medical care, and public health 
services. Four task forces will look at 
factors involved in the provision of hos- 
pital care and services; two groups will 
examine areas pertinent to the provision 
of medical care; the seventh will investi- 
gate costs of public health services. 

(Continued on page 12) 
APRIL 1969 




Barriere-BDH 
silicone 
skin cream 

For skin protection 
against diaper rash 
detergent hands. 

Also indicated 
in colostomy or 
ileostomy drainage. 

Soothes, smooths 
and protects. 



British 
Drug Houses 

(CANADA) LTD. 
TORONTO, CANADA 




APRIL 1969 



THE CANADIAN NURSE 9 



Leadership identified. 





TM 




Consider the responsibilities of leodership in products for intravenous therapy 
...Quality standards must be the highest attainable. And these standards 
must be maintained through constant testing ... checking, and re-testing... 
every step of the way. Making the finest products available is where our 
leadership begins. And so that the finest is readily identified, we've changed 
the names to make them more descriptive. 
Identify with the leader ...C.R. RARD, INC. 

BARDIC Inside needle catheter 

BARDIC Inside needle catheter: The radiopaque catheter is gently inserted into the vein 
from inside the bore of the non-coring needle. The needle is then withdrawn leaving only 
the catheter in the patient's vein. 

BARDIC Around needle catheter 



BARDIC Around needle catheter: The tapered catheter is inserted into the vein from 
P'ound the sharp, non-coring needle. The Around needle catheter placement technique 
allows complete removal of needle leaving only the soft, pliant catheter in the vein. 



INTEGRITY 




C. R. BARD (Canada) LTD. 

22Torlake Crescent, Toronto 18, Ontario 

SINCE ld07 O 



CO. R. BARD, INC. 1969 




(Continued from page 8) 

CNA Asks Government 
For A Million Dollars More 

Ottawa.-l\ie Canadian Nurses' As- 
sociation, in a brief presented this month 
to the Commission on Relations between 
Universities and Governments, re- 
commends that the federal government 
appropriate a minimum of one million 
dollars per year for the preparation of 



nurses at the baccalaureate and master's 
levels, and $100,000 for doctoral study. 
This amount would be in addition to the 
present Professional Training Grant 
Bursaries now being offered. The Bursa- 
ries, CNA recommends, should be used 
only for study at the university level. 

The brief, prepared on behalf of CNA 
by Shirley R. Good, the Association's 
consultant in higher education, noted 
that in 1967-68 the federal government 
allotted $807,247.31 to nursing students 
through the Professional Training Grant 
Bursaries fund. This figure represents a 
decrease of more than $100,000 per 




I 



5i.igi?,'ted Retat! Prices 



At last/ perspiration 
damage meets its match. 

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genuine Servotan* leather, specially treated 
to resist drying, cracking and discoloration 
from perspiration. 

With Servotan, Naturalizers stay softer, more 
comfortable and are so easy to clean with 
soap and water. 

Naturalizers also have the famous Wonder- 
sole (See illustration at right). 





et — 



Wondersole is contoured to 
match the shape of your foot. 
Your body weight is distrib- 
uted evenly along its entire 
length for complete support. 



WITH SERVOTAN AND WONDERSOLE* 

*Trademarl<s of 
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v_-z?5^ Naturalizer Division, Perth, Ontario 

12 THE CANADIAN NURSE 



annum in federal grants to nursing stu- 
dents since 1966-67, and a decrease of 
$152,452.53 compared to the bursaries 
given in 1965-66. The brief noted also 
that in 1967-68, only 8.5 percent of 
nurses studying for baccalaureate degrees 
and 23.2 percent of those enrolled in 
master's studies received financial assis- 
tance from the federal government. No 
figures were available for nurses studying 
at the doctoral level. 

In the brief. Dr. Good pointed out 
that there is an "absolute famine" of 
university-prepared nurses in Canada. The 
CNA's national objective of one nurse 
with a bachelor's degree to three diploma 
nurses has not been reached; the 1968 
ratio was 1:18. Only .5 percent of Can- 
adian nurses hold a master's degree; the 
CNA's objective is 14-15 percent. 

The CNA submission to the Commis- 
sion on Relations between Universities 
and Government also recommends that 
the federal government give an explicit 
and accurate account of monies appro- 
priated to nursing. This would include a 
breakdown of the provinces, institutions, 
and numbers of people involved. 



Professional Institute 
Is Bargaining Agent 
For Federal Nurses 

Ottawa.-lht Professional Institute of 
the Public Service of Canada became the 
certified bargaining agent March 3 for 
2,200 nurses employed by the federal 
government. 

The bargaining unit contains virtually 
all federally employed nurses at the gener- 
al duty, head nurse, and supervisory 
levels. Anne Gribben, employment rela- 
tions director, Registered Nurses' Associa- 
tion of Ontario, said this step "exempli- 
fies just what we're trying to do: create 
unity in the profession. We are nurses 
first — our job classifications are secon- 
dary. 

"It's an idealistic type of composi- 
tion," she continued. It's broad and 
gives all employees the right to bargain." 

Ethel Gordon, consultant for health 
service groups with the PIPS, said the 
Institute is at present working on con- 
tract demands for nurses for the two-year 
period starting July 1, 1967, so the work 
is urgently needed. 

The nursing group is in the scientific 
and professional category of public 
servants. The defence, health and welfare, 
and veterans' affairs departments are the 
prime employers of the nurses. 



Professional Liability Insurance 
Available to ANPQ Members 

Montreal. —kn insurance plan to pro- 
tect professional nurses in the case of 
costly malpractice suits is now available 
to members of the Association of Nurses 

APRIL 1969' 



news 



of the Province of Quebec, after months 
of investigation and study by provincial 
office. This information appeared in the 
January issue of News and Notes, a 
publication of the ANPQ. 

The ANPQ Committee of Management 
recently approved the plan for profes- 
sional liability insurance proposed by the 
Reliance Insurance Company of Canada. 
Although the ANPQ has approved the 
plan, it does not administer it. Nurses 
wishing to avail themselves of this protec- 
tion have been advised to apply directly 
to the insurance company. 

The ANPQ study of professional liabi- 
lity insurance vi'as conducted following 
many requests for information by ANPQ 
members, who were anxious to know if 
such insurance plans were available and 
how they could be obtained. 

AARN Presents Brief To Cabinet 

Edmonton -The Alberta Association 
of Registered Nurses presented its annual 
brief outlining the Association's activities 
and concerns to Alberta Premier Harry E. 
Strom and members of his cabinet Jan- 
uary 10. 

The brief highlighted AARN's progress 
and development during 1968 in the areas 
of nursing service, nursing education, and 
social and economic welfare. Items were 
included on membership statistics, 
developments in nursing education, and 
research programs in which AARN is 
involved. 

The following nursing service items 
were included: 

•• The Alberta Medical Association, the 
Alberta Hospital Association, and AARN 
have endorsed "Guidelines for Medical- 
Nursing Responsibilities" which are now 
being used by medical, nursing, and 
administrative personnel in the develop- 
ment of local policy. 

I AARN's nursing service committee is 
working on guidelines for administrative 
oersonnel in determining hospital staff 
issignments. Registered nurses are per- 
'orming many duties which cannot be 
;lassed as nursing functions, and AARN 
ecommended these non-nursing duties be 
eallocated as far as possible to the 
iepartment involved. Where the nurse 
nust carry some of these duties, a more 
ealistic computation of nursing care 
lours should be carried out. 
• AARN recommended a hospital in- 
dices program, including: study of each 
lospita! as to the influence of variables in 
he staffing pattern; consideration of the 
arious services offered by the hospital 
nd its geographic location; examination 
>f the number of graduate nurse per- 
onnel and their position in each institu- 
APRIL 1969 



tion; and study of the use of registered 
nurses in relation to the activities and 
responsibihties they assume. 

• The brief suggested that "Good Sama- 
ritan" legislation, which would protect 
people from liability for any civil 
damages for acts or omissions at the scene 
of an accident, would be in the public 
interest. Premier Strom requested the 
AARN to submit an outline for proposed 
legislation on this subject to Manitoba's 
Attorney General and Health Minister. 

• AARN has agreed to set down for the 
Hospital Services Division of the Depart- 



ment of Health a definition of nursing in 
terms of goals, in a project "to define 
basic nursing care at the acute, sub-acute, 
chronic and rehabilitative levels." 

• AARN endorsed the recommendations 
of Manitoba's Special Legislative and Lay 
Committee inquiring into Preventive 
Health Services that all the necessary 
health services already in existence be 
invited to participate in an organized 
home care scheme. 

• AARN feels the role of the certified 
nursing aide requires close examination to 
ensure that this role reflects present 




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THE CANADIAN NURSE 13 




hospital requirements. 

The brief was presented by AARN 
President Geneva Purcell, accompanied 
by members of AARN's provincial 
council and standing committee chair- 
men. 



RNAO Plans Programs 
For ICN Visitors 

Toronto. -The Registered Nurses' 
Association of Ontario has invited nurses 
from other countries who are attending 
the International Council of Nurses' 
Congress in Montreal this June to partici- 
pate in the many visits and study pro- 
grams being planned by RNAO. 

RNAO sent a letter, through CNA, to 
each ICN member country, giving infor- 
mation about the programs that will be 
available during either of the two weeks 
preceding or the week following the 
Congress. These include specialized study 
programs, visits to hospitals and health 
agencies; and a symposium on nursing 
service and nursing education to be held 
at RNAO headquarters each of the three 
Mondays preceding the observation visits. 

F. Lillian Campion, RNAO's interna- 
tional secretary on the staff of the Pro- 
fessional Development Department, is in 
charge of the planning. 

Provincial Associations Help 
With ICN Congress 

Ottawa. -Three more provincial nur- 
ses' associations have presented cheques 
to the Canadian Nurses' Association to 
aid in the costs of the XIV Quadrennial 
Congress of the International Council of 
Nurses, June 22 to 28 in Montreal. 

The Saskatchewan Registered Nurses' 
Association has given CNA $3,000; the 
Registered Nurses' Association of Nova 
Scotia has donated $2,000; and the Mani- 
toba Association of Registered Nurses has 
presented $800. 

In addition, six provinces are sending 
their public relations officers to assist at 
the Congress. They are: Claire Marcus, 
from the Registered Nurses' Association 
of British Columbia; Don LaBelle, Alber- 
ta Association of Registered Nurses; Pearl 
Morcombe, MARN; Isabel LeBourdais, 
Registered Nurses Association of Ontario; 
Nancy Rideout, New Brunswick Asso- 
ciation of Registered Nurses; and Gertru- 
de Shane, Registered Nurses Association 
of Nova Scotia. 

In the March issue of The Canadian 
Nurse it was erroneously stated that 
Norma Fieldhouse was RNABC's public 
relations officer. She is public relations 
committee chairman. 
14 THE CANADIAN NURSE 



The Presidents Go For A Ride 




Dr. H.D. Dalgleish, president of the Canadian Medical Association, pulls a 
toboggan-full of CMA-CHA-CNA Conference delegates during time off at the 
Second Canadian Conference on Hospital-Medical Staff Relations in Quebec City. 
Left to right: Sister Mary Felicitas, president of the Canadian Nurses' Association; 
Alan Hay, president of the Canadian Hospital Association; Juliette Pilon, director 
of nursing, Rosemount Hospital, Montreal: Ola Robitaille, director of nursing at 
Jean-Talon Hospital, Montreal; and Helen K. Mussallem, executive director of the 
Canadian Nurses' Association. 



CNA, CMA, CHA Discuss 
Hospital-Medical Staff Relations 

Quebec Ofy. -Doctors, nurses, hospi- 
tal administrators and trustees were 
subject to a sound drubbing at the first 
day of the Second Canadian Conference 
on Hospital-Medical Staff Relations, 
February 17 to 19. Dr. E.W. Barootes, 
chief urologist at Regina General Hospital 
and keynote speaker, accused nurses of 
losing their nursing sense and replacing it 
with a "demoniacal devotion to adminis- 
trative bureaucracy," and administrators 
and other hospital groups of trying to run 
illnesses on a nine to five daily basis. 
Doctors were attacked for keeping pa- 
tients in hospital only because it is easier 
to care for them there than at home. 

The conference was sponsored jointly 
by the Canadian Hospital Association, the 
Canadian Medical Association, and the 
Canadian Nur§es' Association to improve 
communication among hospital person- 
nel. Alan Hay, president of the CHA, 
presided over the conference. 

Dr. Barootes' address was supple- 
mented on the final day of the confe- 
rence by an address by Dr. A.B. Powell, 
director of medical services for the Onta- 
rio Workmen's Compensation Board, enti- 
tled "Effective Medical Services." 

The participants of the conference 
were divided into four study groups of 



approximately 100. Before beginning 
their discussions, the groups were addres- 
sed by Russell J. Porter, principal asso- 
ciate of Willson Associates, Limited on 
"Conference Goals." 

At the conclusion of the conference, 
the four group leaders presented reports 
on the progress of their groups. The first 
report, delivered by W.C. Gardner, listed 
several recommendations, including: 
regionalization of conference workshops 
with regard to size and areas of problems; 
circulation of agenda prior to conferences 
and the discussion of questions and topics 
of each group present. 

Group II, represented by Dr. P.M. 
Christie, recommended that regional con- 
ferences run by the three sponsoring 
associations be established, and that the 
national conference be less frequent. 

Group III made one recommendation, 
presented by Dr. K.H. MacKay: that the 
Canadian Hospital Association, the Cana- 
dian Medical Association, and the Cana- 
dan Nurses' Association approach the 
proper authorities so that research funds 
will be increased to attract medical and 
nursing teachers of the highest calibre. 

The fourth group, which was conduc- 
ted in French, made several recommen- 
dations, including the following: that Dr. 
Barootes' speech be translated into 
French and distributed in either language 

APRIL 1969 




to participants; that the participants be 
given a choice of groups; and that French 
and English groups be intermingled, with 
simultaneous translation. 

The third conference will be held in 
Banff, Alberta, next year. 

CNF Board Meets 

And Appoints New Officers 

Ottawa. -The Canadian Nurses' Foun- 
dation's board of directors elected Hester 
J. Kernen, associate professor in public 
health nursing, University of Saskatche- 
wan, as president, and Albert Wedgery, 
associate director. College of Nurses of 
Ontario, as vice-president at its meeting at 
National Office March 10. 

The CNF board also appointed mem- 
bers to the nominating and selections 
committees of the Foundation. Names of 
members will be released on their accept- 
ance of the appointments. 

Concern about the low membership in 
CNF was expressed by the board mem- 
bers. They agreed that a letter should be 
sent to former CNF scholars, asking for 
their support in promoting the Foun- 
dation. Because of the present financial 
situation of CNF, the board agreed that 
priority must continue to be given to 
scholarships, rather than to research, to 
help prepare nurses for positions of re- 
sponsibility. 

To date, approximately $35,000 is 
available for 1969 fellowship awards, as 
compared to 557,000 awarded in 1968. 
Membership in CNF can be obtained by 
sending a cheque for two dollars to: CNF, 
50 The Driveway, Ottawa 4. Fees and 
donations are tax deductible. 

Two Students Selected 
To Attend ICN Congress 

Sudbury. -Two students at Laurentian 
University School of Nursing will be given 
financial assistance to attend the XIV 
Quadrennial Congress of the International 
Council of Nurses to be held June 22 to 
28 in Montreal. 

Louise Picard and Rosemary Boyle 
were selected to receive the award. It is 
given in memory of Wilda Sims, a former 
faculty member at Laurentian University, 
who died in December 1968. During her 
25 years as nurse educator, over 600 
students graduated under her adminis- 
tration. 



"NBARN Sponsors Inservice 
Education Workshop 

Memramcook, N.B. -"Better Patient 
Care with Inservice Education" was the 
APRIL 1%9 



theme of a two-day workshop held here 
in March. Sponsored by the nursing servi- 
ce committee of the New Brunswick 
Association of Registered Nurses, the 
workshop was expected to attract nurse 
representatives from some 30 hospitals 
and agencies in the province. 

Workshop leader was Mona Callin, 
lecturer in nursing. McGill University, 
Montreal. Miss Callin's background is in 
the area of adult education and inservice 
coordination. 

Purpose of the workshop was to assist 
in improving patient care in New Bruns- 
wick by improving inservice education 



programming for nursing service staff. 
Topics included: inservice education 
philosophy and objectives; obstacles to 
effective inservice programming; adult 
versus youth learning; philosophy of 
adult education; types of leadership; 
effective group efforts; planning an in- 
service project. 

NLN Conference To Consider 
Health in Community 

New Forfc -"Partners for Health - 

Nursing and the Community" is the 

(Continued on page 18) 



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THE CANADIAN NURSE 15 



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Sets-up fast, changes fast. That's uromatic plastic irrigating con- 
tainer. The new plastic irrigation solution container that stops 
irrigation procedures from becoming irritation procedures. They're 
lighter, easier to handle, and safer to hong than conventional 
gloss bottles. Now every procedure is a safe procedure. 

The UROMATIC container changes everything 
but the technique. 

Three special ports let you use familiar 
techniques. But there is one big differ- 
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or cops. Set-ups and change-overs 
ore faster and more aseptic 
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From set connection through 
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{Continued from page 15) 
theme of the National League for Nursing 
Convention to be held in Detroit, May 
19-23. Keynote speaker will be Dr. Philip 
M. Hauser, director of the Population 
Research Center and professor of sociol- 
ogy at the University of Chicago, who 
will speak on "Urban USA - A Chaotic 
Society? " 

The convention participants will con- 
sider the theme in large general sessions, 
in "think-ins and talk-backs," at luncheon 
meetings, and at seminars throughout the 
convention. Other speakers include L. 
Ann Conley, president of NLN; Dwight 
L. Wilbur, president of the American 
Medical Association; Margaret B. Dolan, 
head of the department of public health 
nursing at the University of North Caro- 
lina; and Richard Magraw, deputy assist- 
ant secretary for health manpower, US 
Department of Health, Education, and 
Welfare. 

Panel discussions will consider 
"Mobilizing for Community Health," and 
will take a new look at the people who 
make up today's health team. During the 
week, other programs designed to bring 
information to members on new methods 
of health care are scheduled. All NLN 
councils of agency members will meet 
during convention week, and the annual 
convention of the National Student 
Nurses' Association will take place in the 
week preceding the conference in Chi- 
cago. 

ICN Nominations Announced 

Geneva, Switzerland -~ Nominees for 
elected positions in the International 
Council of Nurses for 1969-1973 were 
announced early in 1969 in Geneva. 
Elections will take place during ICN's 
14th quadrennial congress in Montreal, 
June 22-28. Votes may be cast by the 
Council of National Representatives, 
composed of the presidents of the 63 
national nurses' associations in member- 
ship with ICN. 

To be elected for the four-year term 
are a president, three vice-presidents, 
board of directors, and members of the 
standing committees on membership and 
professional services. Each nominee has 
been certified as a nurse who is an active 
member in a member association. 

Two nurses have been nominated as 
ICN president: Margrethe Kruse, chair- 
man of ICN's Professional Services Com- 
mittee 1965-69 and executive secretary 
of the Danish Nurses' Organization: and 
Dame Muriel Powell. DBE, member of 
the ICN Board of Directors 1965-1969 
and matron at St. George's Hospital, 
London, U.K. 



18 THE CANADIAN NURSE 



There are three nominees for the three 
posts of first, second and third vice- 
president: Dorothy A. Cornelius, pre- 
sident, American Nurses' Association; 
Ruth Elster, ICN second vice-president, 
1965-1969, and president, German Nur- 
ses' Federation; and Alice Girard, ICN 
president. 1965-1969, of Canada. 

Nominees for the Board of Directors 
are: Nicole F. Exchaquet, Switzerland; 
Barbara Fawkes, U.K.; Nelly Goffard, 
Belgium; Jadwiga Izycka, Poland; Docia 
A.N. Kisseih, Ghana; Jane Martin, France; 
Joyce C. Rodmell, Australia; Julita V. 
Sotejo, Philippines; Gerd Zetterstrom 
Lagervall, Sweden. 

Sixteen nurses have been nominated 
for membership on the ICN Membership 
Committee, including Lyle Creelman, a 
member of the Canadian Nurses' Associa- 
tion and formerly chief nurse. World 
Health Organization. Among the 23 
nominees for the Professional Services 
Committee is Laura W. Barr, executive 
director of the Registered Nurses' Asso- 
ciation of Ontario and member of this 
committee in I965-I969. 

Hospital Personnel Relations 
Bureau Set Up 

Toronto. Any hospital in Ontario can 
now turn to the Hospital Personnel Re- 
lations Bureau for help in dealing with 
labor problems. 

By the end of January, the bureau's 
first month of full-time operation, 56 
Ontario hospitals had joined this inde- 
pendent organization. Ontario is the fifth 
province to form such a "self-help'' 
central bargaining body. 

The bureau concept developed 
through several meetings of the Ontario 
Hospital Association. At a meeting of 
OHA representatives in March 1968, a 
basic bargaining problem was seen in 
negotiations carried out by management 
representatives of an individual insti- 
tution who were sometimes less knowl- 
edgeable than their union counterparts. 
OHA representatives believed that such a 
situation tended to expose hospitals to: 
one institution "playing off another. 
and similar and separate negotiations 
occurring in one hospital industry in a 
given time, thus making invidivual nego- 
tiations very time-consuming. 

The main function of the bureau is to 
coordinate the labor relations efforts of 
its member hospitals for their mutual 
advantage. The bureau emphasizes, how- 
ever, that it has no intention of inter- 
fering with the autonomy of any hospital, 
and will act only when authorized by a. 
hospital. 

D. Alan Page, manager of the bureau, 
says that the bureau's services are design- 
ed to help hospitals with or without 
unions. 

The objectives of the bureau include: 
• Development of uniform contracts in 
regions of the province. 

APRIL 1969 



news 



• Acting as a source of information on 
hospital labor matters. 

• Maintenance of fair salary scales for all 
hospital employee classes. 

• Interpretation of contracts and assis- 
tance in gaining settlement of disputes. 

• Investigation of salaries for nurses and 
other paramedical people. 

• Establishing relations with other 
similar bodies in Canada. 

Quebec Male Nurses 
Seek Legal Recognition 

MontreaL -"Mile nurses in the pro- 
vince of Quebec are not losing hope even 
though their grievances were not discuss- 
ed at the last session of the Quebec 
parliament," said Jean Robitaille, pre- 
sident of the Graduate Male Nurses of 
Quebec in an interview with L 'infirmiere 
canadienne. 

Male nurses at present do not have any 
legal status in Quebec and cannot legally 
be hired to practice as nurses in the 
province. There are 525 male nurses in 
Quebec, many of whom hold a bachelor's 
or even a master's degree in nursing, 
despite the fact that they do not possess 
legal authorization to practice in Quebec. 
The Association of Nurses of the Province 
of Quebec fully supports the principle 
that male nurses should be authorized to 
practice; however, the Association cannot 
grant them registration until the present 
nursing act is amended by the Quebec 
parliament. 

"In 1966 the legal right of male nurses 
to practice in Quebec was included in an 
amendment to the Quebec Nurses' Act 
and scheduled to be discussed in the 
Quebec parliament," continued Mr. Robi- 
taille. "Since that time, there has been a 
provincial election and a change in the 
government. The late Premier Daniel 
Johnson promised to consider our pro- 
blem, and at the last session, the dis- 
cussion on Bill 85 - which concerns the 
'ights of minorities in Quebec - took 
oriority over discussion of our proposed 
amendments to the Nurses' Act. We 
iincerely hope that the amendment will 
le discussed and approved during the 
Parliamentary session that began Febru- 
iry 25." 

Maurice Jacques, the lawyer represent- 
ng the Quebec male nurses, plans to meet 
n the near future with Jean-Paul Clou- 
ier, Quebec's minister of health, to im- 
)ress upon him the urgency of the pro- 
'lem. 

"led Cross Bursary 
Dffered to Ontario Nurses 

Toronto.- A SI, 000 bursary is being 
'ffered to graduate nurses registered in 
KPRIL 1969 



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THE CANADIAN NURSE 19 



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Ontario by the Volunteer Nursing 
Committee of the Canadian Red Cross 
Society. The award is to enable the 
recipient to take further studies in nurs- 
ing at the degree level. 

The successful candidate will be select- 
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sideration is also given to the applicant's 
anticipated contribution to nursing in 
Ontario. 



Butterfly With a Broken Wing 




20 THE CANADIAN NURSE 



Montreal -The Quebec Society for 
Crippled Children has adopted a new 
emblem — a butterfly with a broken 
wing. The symbol will appear on the 
Society's stationary, its cars, and on all 
materials used in this year's fund-raising 
campaigns. 

According to a brochure sent out by 
the Society, last year $103,914 was 
spent on orthopedic appliances, wheel- 
chairs, special shoes, braces, and other 
equipment necessary for young handi- 
capped children. The society also pro- 
vided speciahzed medical and nursing 
care for handicapped youngsters and 
provided camps and treatment centers 
for nearly 500 physically handicapped 
children. 



Naegeie Fund Trustees Report 
On Progress Of Children 

Vancouver. — Trustees of the Kaspar 
Naegeie Educational Trust Fund have 
reported on the progress of Dr. Naegele's 
three children. Dr. Naegeie, formerly 
Dean of Arts at the University of British 
Columbia, was preparing a study of nurs- 
ing education in Canada at the time of his 
death in 1965. 

The Educational Trust Fund was set 
up shortly after Dr. Naegele's death to 
provide for the education of his three 
children. Helen K. Mussallem, executive- 
director of CNA, is one of the trustees, 
CNA donated the remaining money set 
aside for Dr. Neagele's report, some 

APRIL 1969 



news 



SI, 200, to the Fund. Several nurses 
donated individually. 

The report says that Janet and Tim- 
othy, the younger children, have rejoined 
their mother in Vancouver after a stay 
with their uncle in Northampton, 
Massachusetts. They are now in school in 
Vancouver. Barbara, the eldest child, is in 
her final year of science at UBC. 

Health & Welfare Department 
Marks 50th Anniversary 

Ottawa. -This year the Department of 
National Health and Welfare marks the 
achievement of 50 years of service to the 
people of Canada. 

Specials events are taking place during 
April to mark this anniversary, plus 
publication of a commemorative issue of 
the Department's magazine Canada's 
Health and Welfare. 

The Department was first formed as 
the Department of Health in 1919. In 
1929 it was renamed the Department of 
Pensions and National Health. Its broad 
purpose has been to provide all Canadians 
with the highest standards of personal 
and collective health, and to provide 
assistance to the many who cannot or 
only partially can assist themselves in the 
i business of daily living. 

The activities of the Department 
during the first half of these 50 years 
were of a curative nature, devoted to 
attempts to solve problems that had 
grown beyond the capabilities of pro- 
vincial and private organizations. 

Considering the present-day concern 
with water pollution, it comes as a 
surprise to realize that as early as 1923 a 
division for its control was established 
within the Department. 

The second 25 years, however, have 
been marked by the assumption of a 
preventive task. Much more effort has 
been devoted to allaying the cause of 
illness, and much new legislation has been 
geared to provide security and health 
benefits for the young, the old and the 
infirm. This new direction was demon- 
strated in 1944 when the Department was 
given its present title. 

This reorganization drew together 
activities that had been the responsibi- 
lities of other departments. Divisions 
directing their efforts to new areas of 
national health and welfare were started. 
Things have happened thick and fast 
during the last decade, most recently the 
Canada Pension Plan of 1965, the sub- 
sequent Guaranteed Income Supplement, 
ind the Canada Assistance Plan. These 
Tiany social legislations are either a total 
ederal responsibility or operated jointly 
■vith the provinces. 

APRIL 1969 



Charge Made For 
Study Tours To UK 

London. England. -A charge of 10 to 
15 pounds will now be made for study 
tours in the United Kingdom for overseas 
nurses arranged by the Royal College of 
Nursing and National Council of Nurses 
of the United Kingdom. A charge of one 
pound will also be made for work under- 
taken by RCN's international department 
on behalf of foreign nurses wishing to 
work in the UK. 

This new ruling took effect April 1, 



1969. The decision was taken to offset to 
some extent the heavy administrative 
expenses of the international department 
rather than to curtail the facilities offered 
by the department for nurses from 
abroad. There may be exceptional cir- 
cumstances when this general ruling 
should be waived. 

The charge for a study tour will vary 
depending on its length and complexity. 
A charge is also made for work under- 
taken by the international department for 
RCN members wishing to work or study 
overseas. Q 





For nursing 
convenience... 

patient ease 

TUCKS 

offer an aid to healing, 
an aid to comfort 

Soothing, cooling TUCKS provide 
greater patient comfort, greater 
nursing convenience. TUCKS mean no 
fuss, no mess, no preparation, no 
trundling the surgical cart. Ready- 
prepared TUCKS can be kept by the 
patient's bedside for immediate appli- 
cation whenever their soothing, healing 
properties are indicated. TUCKS allay 
the itch and pain of post-operative 
lesions, post-partum hemorrhoids, 
episiofomies, and many dermatological 
conditions. TUCKS save time. Promote 
healing. Offer soothing, cooling relief 
in both pre-and post-operative 
conditions. TUCKS are soft 
flannel pads soaked in witch hazel 
(50%) and glycerine (10%). 



TUCKS — the valuable nur- 
sing aid, the valuable patient 
comforter. 



MWINLEY-MORRIS ^6. 
MONTREAL CANADA 

TUCKS Is a trademark of the Fuller Laboratories Inc. 
THE CANADIAN NURSE 21 



names 




Eleanor Mitchell 

joined the staff of 
The Canadian Nurse 
as assistant editor in 
March 1969. A 
graduate of the To- 
ronto General Hospi- 
tal School of Nurs- 
ing. Miss Mitchell 
received a postgradu- 
ate diploma in neurological nursing from 
the Montreal Neurological Institute, and a 
Bachelor of Nursing Degree from McGill 
University. 

The new assistant editor has had ex- 
perience on the neurosurgical unit at 
Toronto General Hospital and for several 
years was assistant director of nursing 
education in charge of a nursing assis- 
tants' program at Peel Memorial Hospital 
in Brampton. Ontario. Before coming to 
Ottawa, she taught students at the Credit 
Valley School of Nursing in Mississauga. 
Ontario. 

Edna L. Moore, a pioneer in public 
health nursing, died in Toronto February 
25 at the age of 77. 

Dr. Moore's active, 44-year nursing 
career began in 1913 when she graduated 
from the Toronto General Hospital 
School of Nursing. After working two 
years at TGH. Dr. Moore spent four years 
overseas as a Nursing Sister with the 
Canadian Army Medical Corps. She re- 
turned to Canada to work as a social 
service nurse with the Department of 
Soldiers Civil Re-establishment. 

Dr. Moore first worked for the Ontario 
Department of Health as a social service 
nurse with the Division of Preventable 
Diseases from 1 920-24. She then went to 
New York State, first as a supervisor of 
social hygiene and two years later as the 
assistant director of the national organiza- 
tion for public health nursing. While in 
the United States. Dr. Moore studied 
maternal and child hygiene, venereal 
disease control, social work, and tubercu- 
losis control. From 1927 to 1929 she was 
a field worker with the Canadian Tuber- 
culosis Association in Ottawa. 

In 1931 Dr. Moore joined the Ontario 
Department of Health as chief public 
health nurse. She became the first direc- 
tor of the Public Health Nursing Division 
when it was formed in 1944, the position 
she held until her retirement in 1957. 

Dr. Moore's leadership extended to 
many professional associations. She ser- 
ved on the editorial board of the Can- 
adian Journal of Public Health; was a vice 
22 THE CANADIAN NURSE 



president of the Canadian Public Health 
Association from 1956-57: was first vice 
president and then president of the Onta- 
rio Public Health Association from 
1953-54; and was elected first vice pre- 
sident of the Registered Nurses" Associa- 
tion of Ontario in 1946. After retirement, 
she conducted a study of nursing regis- 
tries for the RNAO. From 1940 to 1947, 
Dr. Moore served as chairman of the 
Public Health Committee of the Inter- 
national Council of Nurses. She was also 
active in the Canadian Red Cross. Ontario 
Society for Crippled Children. Canadian 
Cancer Society, and the Nursing Council 
of the University of Toronto School of 
Nursing. 

In recognition of her leadership, Dr. 
Moore received the Associate Royal Red 
Cross in 1919, the George V Jubilee 
medal, and was made a Fellow of the 
American Public Health Association. In 
1956 the University of Western Ontario 
honored Dr. Moore for her public health 
service with an honorary Doctor of Laws 
degree. In 1968 at Laurentian University 
in Sudbury, Ontario, she presented the 
first Dr. Fdna L. Moore scholarship - 
awarded, most fittingly, for excellence in 
the practice of nursing. 

Mother Virginie 
Allaire, founder of 
L'Institut Marguerite 
d'Youville. the first 
school of higlier 
education for 
French-speaking 
nurses, died in Jan- 
uary at the mother- 
house of the Grey 
Nuns of Montreal. 

Born in Grafton, Massachusetts, 
Mother Allaire joined the Order of the 
Grey Nuns of Montreal in 1904. Later, 
she returned to the U.S. to complete her 
nursing education at Morristown Hospital 
in New Jersey. Her professional career 
included: director of nurses at St. Peter's 
Hospital in New Brunswick. New Jersey; 
provincial superior at St. Boniface: 
business manager of the Grey Nuns of 
Montreal community: and director of 
L'Institut Marguerite d'Youville, which 
she founded in 1934. 

During her lifetime. Mother Allaire 
received recognition from many organiza- 
tions for her outstanding contributions to 
nursing and to various professional as- 
sociations. In 1936, she was awarded an 
honorary doctoral degree by the Univer- 
sity of Montreal: in 1940, she received 






the silver medal of the Canadian and U.S. 
hospital associations for distinguished 
service: she was made a Fellow of the 
American College of Hospital Adminis- 
trators; and in 1960 she was made an 
honorary member of the Canadian 
Nurses' Association. 

Elaine Audrey 
McEwan (B.N., U. 
New Brunswick: 
M.Sc.N., Cert. 
N u rse-Midwifery, 
Yale U., Mass.) has 
been appointed 
lectu rer at the 

/I ^ A school of nursing, 
Jm m jM University of New 
Brunswick. Miss McEwan assumed her po- 
sition in July 1968. 

Annetta L. 
Landon (Reg.N., To- 
ronto General; Dipl. 
Teach. & Superv.. 
McGill U.) recently 
retired from her 
position as director 
of nursing services at 
w»'| ^m Ottawa Civic Hospi- 
'«t| H tal after 22 years ol 
service at the Civic. Before coming tc 
Ottawa. Miss Landon worked at Toronto 
General Hospital for 1 6 years as operating 
room nurse, supervisor of the radiology 
department, and operating room super- 
visor. 

Throughout her nursing career. Miss 
Landon has been active in the Registerec 
Nurses' Association of Ontario. 



Sixteen new instructors joined thi 
staff of the school of diploma nursing a 
the Saskatchewan Institute of Appliet 
Arts and Sciences, Saskatoon, in Septem 
ber 1968. 

Charlotte A. Annable (B.S.N., U 
Saskatchewan) formerly worked as a gen 
eral duty nurse at The Winnipeg Genera 
Hospital. Rose-Aline Begalke (R.N., Sas 
katoon City H., Dipl. Teach. & Superv. 
U. Saskatchewan) tauglit pediatrics fo 
one year at Medicine Hat General Hospi 
tal. Alberta, and orthopedics and urologj 
for two years at St. Paul's Hospital ii 
Saskatoon. 

S. Maureen Campbell (R.N., Misericor 
dia General, Winnipeg; Dipl. P.H.N, 
McGill U.) formerly was employed by th' 
Saskatchewan government as a publii 
health nurse in Unity, Saskatchewan an( 

APRIL 196« 



names 



Meadow Lake. Saskatchewan. Miss Camp- 
bell has also worked as a general duty 
nurse in Germany, Maryland, California, 
and Saskatchewan. 

K. Anne Harris (Reg.N,, Ontario H., 
Brockville: Dipl. Nurs. Educ. U. Western 
Ont.) comes to Saskatchewan from 
Brockville where she was an instructor at 
the Ontario Hospital. Joyce M. Klingman 
(R.N., Yorkton Union H., Sask.: Dipl. 
Teach. & Superv., U. Alberta) previously 
spent a year at Yorkton Union Hospital 
as a general duty nurse. 

Phyllis E. McElroy (R.P.N.. Saskat- 
chewan H., Weyburn; Dipl. Teach. & 
Superv., U. Saskatchewan) has had 10 
years experience as an instructor for the 
Saskatchewan department of health at 
Yorkton Psychiatric Centre and in 
Weyburn. 

Donna C. Miller ( B.S.N. , U. Saskat- 
chewan) previously taught for a year at 
the school of nursing. University of 
Saskatchewan. Patricia A. Meyer (R.N.. 
Regina Grey Nuns' H.; B.Sc.N.. U. Wind- 
sor) formerly worked as a general duty 
I nurse at Regina Grey Nuns' Hospital. 

Stella Pankratz (R.N., U. Saskatche- 
wan; B.Sc.N.. U. Alberta) has worked as a 
staff nurse at St. Margaret's Hospital, 
Biggar, Saskatchewan, and at Rosthem 
Union Hospital, Saskatchewan. From 
1967 until her present appointment, she 
has been head nurse at Glenrose Pro- 
vincial Hospital in Edmonton. Sheila E. 
Perry (R.N.. The Winnipeg General Dipl. 
Teach.. U. Saskatchewan) has worked as 
a general duty nurse at The Winnipeg 
General Hospital, St. Joseph's General 
Hospital in Estevan. Saskatchewan, and 
University Hospital. Saskatoon. 

Blondina F. Peters (R.N., B.Sc.N., U. 
Saskatchewan) previously worked at 
Kingston General Hospital. Ontario and 
University Hospital. Saskatoon as a staff 
nurse. Olivia M. Sane (R.N., Regina Grey 
Nuns' H.: Dipl. Teach. & Superv.. B.ScJ^i.. 
U. Saskatchewan) formerly worked as 
jn instructor in Moose Jaw, Regina. 
Dttawa, and Hamilton. 

Judith M. Scanlan (R.N., Regina Gen- 
eral; B.N.. U. Manitoba) comes to Sas- 
;atoon from Winnipeg where she taught 
!t The Children's Hospital of Winnipeg, 
ihe had previously worked as a general 
iuly nurse in North Vancouver and 
Vinnipeg. Catherine M. Seymour ( B.Sc.N., 
J. Saskatchewan) formerly worked for a 
ear as an instructor at Holy Cross Hospi- 
al in Calgary. 

Nevin N. Surring (R.P.N.. Saskat- 
hewan H.. Weyburn: Dipl. Teach. & 
)Uperv.. U. Saskatchewan) has experience 
s an instructor at Yorkton Psychiatric 
entre. Saskatchewan and Saskatchewan 
iPRiL 1969 



Hospital in Weyburn. Mary A. Symon 

(R.N.. Regina Grey Nuns' H.; Dipl. P.H., 
U. Manitoba) previously worked in Sas- 
katoon's St. Paul's Hospital as a staff 
nurse, head nurse, and instructor, and in 
Calgary's Holy Cross Hospital as a health 
nurse. 





Joyce O. Shack 

(Reg.N., Victoria H.. 
London. Ont.; Dipl. 
Nurs. Educ., 
B.Sc.N., U. Western 
Ont.) has been 
named director of 
nursing service at 
Plummer Memorial 
Public Hospital in 
Sault Ste. Marie, Ontario. Miss Shack 
leaves her position as director of nursing 
service at St. Joseph's Hospital, Sarnia, 
Ontario. She has also held positions as a 
general duty nurse at Victoria Hospital. 
London, Ontario; head nurse at Syden- 
ham District Hospital, Wallaceburg, Onta- 
rio; and instructor at Sarnia General 
Hospital, Ontario. 

M. Colleen Stain- 
ton (R.N., The Van- 
couver General; 
B.Sc.N., U. British 
Columbia) has been 
named instructor in 
maternal and child 
care at Mount Royal 
Junior College, Cal- 
gary. 

Miss Stainton previously was an in- 
structor in medical-surgical nursing at 
Foothills Provincial General Hospital, 
Calgary. From 1963 to 1966, she was an 
instructor in obstetrical nursing at Holy 
Cross Hospital in Calgary. 

Ethel M. Gordon 

(R.N.. The Winnipeg 
General . ; Dipl. 
P.H.N., U. Toronto) 
former chief nursing 
advisor in the Public 
Service Health Di- 
\ ision of the Depart- 
ment of National 
Health and Welfare 
has retired after 21 years service. Miss 
Gordon has now taken a new position 
with the Professional Institute of the 
Public Service of Canada as nursing con- 
sultant. 

Miss Gordon joined the former Civil 
Service Health Division as assistant super- 
visor of nursing councellors in 1947. In 
1953, she became chief nursing advisor, 
which involved directing the nursing 
counsellor service for public servants in 
the national capital area. 

Following graduation, Miss Gordon 
was nursing supervisor at The Winnipeg 
General Hospital and at the same time 





engaged in studies at Manitoba Med- 
ical College. 

In 1937, she joined the Victorian 
Order of Nurses and remained on their 
staff until she came to the Department of 
National Health and Welfare. 

Corazon Ignacio (B.Sc.N., U. Santo 
Tomas. Manila. Philippines) has been 
named inservice education coordinator at 
St. Elizabeth Hospital in North Sydney, 
Nova Scotia. Mrs. Ignacio comes to St. 
Elizabeth's after one-and-one-half years as 
head nurse at Ottawa General Hospital. 
She had previously worked in hospitals in 
Cincinnati and Cleveland, Ohio, as staff 
nurse and operating room nurse. 

Helen Cunning- 
ham (Reg.N., Ot- 
tawa Civic H.; B.N., 
McGill U.) recently 
was appointed direc- 
tor of nursing servi- 
ces at Ottawa Civic 
Hospital. Miss Cun- 
ningham has spent 
most of her nursing 
career at Ottawa Civic Hospital. Previous 
to her present appointment, she was 
associate director of nursing service. She 
has also worked at the Civic as a staff 
nurse, assistant head nurse, head nurse, 
chnical instructor, and executive assistant 
to the assistant director of nursing. 

M a rgaret C. 
Cahoon (Reg.N., 
Women's College H., 
Toronto; B.A., 
Queen's U.;Cert.Ph., 
B.Ed., M.Ed., U.To- 
ronto; Ph.D., U. 
Michigan) has been 
appointed associate 
professor in the 
school of nursing and the school of 
hygiene at the University of Toronto. Dr. 
Cahoon had been assistant professor in 
the School of Hygiene, University of 
Toronto since 1963 and visiting lecturer 
to the School of Nursing, University of 
Toronto since 1961. 

She began her nursing career as a 
public health nurse for the Board of 
Health in Picton, Ontario. She then work- 
ed as a public health nurse for the 
Ontario Cancer Research and Treatment 
Foundation in Kingston, Ontario. Dr. 
Cahoon then moved to Toronto to be- 
come a fellow in public health and 
subsequently an associate in health educa- 
tion at the School of Hygiene, University 
of Toronto. 

Dr. Cahoon has been active through- 
out her nursing career in the Registered 
Nurses' Association of Ontario, serving on 
various executive committees. She was a 
Worid Health Organization Fellow from 
1963 to 1964. n 

THE CANADIAN NURSE 23 




April 14 - May 9, 1969 
May 12 - June 6, 1969 

Rehabilitation Nursing Workshops, 
University of Toronto. Four-week 
course for R.N.s employed in acute 
general and chronic illness hospitals, 
nursing homes, public health agencies, 
and schools of nursing. Tuition fee: 
$150. Apply to: Division of University 
Extension, Business and Professional 
Courses, 84 Queen's Park, Toronto 5. 

April 20, 1969 

Second Annual Dialysis Symposium 
for Nurses, held in conjunction v^^ith 
annual meeting of American Society 
for Artificial Internal Organs, at Chal- 
fonte-Haddon Hall, Atlantic City, New 
Jersey. Organized by the US Public 
Health Service's Kidney Disease Con- 
trol Program. For further information 
write: Michael A. Byrnes, Information 
Services Section, Dept. of Health, Edu- 
cation, and Welfare, Public Health 
Service, Health Services and Mental 
Health Administration, 4040 North 
Fairfax Dr., Arlington, Virginia 22203. 

April 28 - May 2, 1969 

Final workshop of the Extension 
Course in Nursing Unit Administra- 
tion, Regina, offered in English and 
French to registered nurses in adminis- 
trative positions who are unable to 
attend university. Sponsored by the 
Canadian Nurses' Association and the 
Canadian Hospital Association. Write 
to: Director, Extension Course in Nurs- 
ing Unit Administration, 25 Imperial 
Street, Toronto 7. 

May 1-3, 1%9 

Registered Nurses' Association of On- 
tario, annual meeting. Royal York 
Hotel, Toronto. 

May 5-7, 1969 

Workshop for teachers on test cons- 
truction, conducted by Professor V. 
Wood, School of Nursing, The Univer- 
sity of Western Ontario. Theme: Task- 
oriented work sessions on essay ques- 
tions, models for marking essay ques- 
tions; objective examinations and 
item-writing practice sessions; and 
final assessment of student nurses. 
Send applications to: Miss Angela Ar- 
mitt. Summer School and Extension 
Department, The University of West- 
ern Ontario, London, Ont. 
24 THE CANADIAN NURSE 



May 5-7, 1969 

Association of Registered Nurses of 
Newfoundland, annual meeting. Au- 
ditorium, Nurses' Residence, Western 
Memorial Hospital, Cornerbrook. 

May 12, 1969 

Alumnae Association of the Toronto 
General Hospital School of Nursing, 
75th anniversary. Events for the week 
of May 12 include tours of the new 
school and residence, graduation exer- 
cises, and dinner at the Royal York 
Hotel. For dinner tickets ($8.50) and 
further information write: Mrs. Grieg 
Brown, 27 Thorncliffe Park Drive, Apt. 
301, Toronto 17. 

May 12-14, 1969 

St. Boniface School of Nursing, Mani- 
toba, class of 1944 will hold its 25- 
year reunion. For information write 
Mrs. M. Gyde, 13 Pawnee Bay, St. 
Boniface 6, Man. 

May 13-16, 1%9 

Alberta Association of Registered 
Nurses, annual convention, Macdo- 
nald Hotel, Edmonton, Alberta. 

May 19-23, 1%9 

National League for Nursing, 1969 
convention. To be held in Cobo Hall, 
Detroit, Michigan. Fee: NLN members, 
$15; non-members, $25. Write to: 
NLN, 10 Columbus Circle, New York, 
N.Y. 10019. 

May 20-23, 1969 

Canadian Public Health Association 
annual meeting. Hotel Nova Scotian, 
Halifax. Theme: The child in contem- 
porary society. Write to: Canadian 
Public Health Association, P.O. Box 
2410, Halifax, N.S. 

May 21-23, 1%9 

Saskatchewan Registered Nurses' As- 
sociation, annual meeting, Bessbor- 
ough Hotel, Saskatoon. 

May 21-23, 1969 

Registered Nurses' Association of Brit- 
ish Columbia, annual meeting, Bay- 
shore Inn, Vancouver. Write: RNABC, 
2130 W. 12th Ave., Vancouver 9. 

May 23-25, 1969 

Reunion of Moose Jaw Union Hospital 



Alumnae Association, Moose Jaw, 
Sask. Members of all classes 1909-69 
are welcome. Write to: Alumnae Reu- 
nion Committee, c/o Mrs. A. Kitts, 870 
Stadacona St., W., Moose Jaw, Sask. 

May 28-29, 1969 

Registered Nurses' Association of 
Nova Scotia, annual meeting, Yar- 
mouth. 

May 28-30, 1969 

The New Brunswick Association of 
Registered Nurses, annual meeting. 
New Brunswick Hotel, Moncton. 

May 29-30, 1%9 

Manitoba Association of Registered 
Nurses, annual meeting, Brandon 
General Hospital School of Nursing 
Building, Brandon. 

lune 1-13, 1969 

8th Annual residential summer course 
on alcohol and problems of addiction, 
Trent University, Peterborough, Onta- 
rio. Cosponsored by Trent University 
and the Addiction Research Founda- 
tion of Ontario. Enrollment is limited 
to 80 persons. The $250 fee includes 
meals, tuition and accommodations. 
Write to: Summer Course Director, 
Education Division, Addiction Research 
Foundation, 344 Bloor St. W., To- 
ronto 4. 

lune 16-18, 1969 

Conference on nursing education for 
visitors to the International Council of 
Nurses Quadrennial Congress. Spon- 
sored by the school of nursing and 
alumni association. University of To- 
ronto. June 19-20: tours in Toronto 
and environs to be arranged at re- 
quest of persons attending conference. 
Apply to the Secretary of the School, 
University of Toronto School of Nurs- 
ing, 50 St. George St., Toronto 5. 



lune 22-28, 1969 




International Coun- 
cil of Nurses' Qua- 
drennial Congress, 
Montreal. Fee: $60. 
Write to: ICN Con- 
gress Registration, 
50 The Driveway, 
Ottawa 4, Ont. D 



APRIL 1969- 




your 

Own 

hands: 



■%, 




soft testimony to your patients' comfort 

Your own hands are testimony to Dermassage's effectiveness. Applied by your 
soft, practiced hands, Dermassage alleviates your patient's minor skin irritations 
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned 
skin ; relieves dryness, itching and cracking . . . aids in preventing decubitus 
ulcers. In short, Dermassage is "the topical tranquilizer". . , it relaxes the patient 
. . . helps make his hospital stay more pleasant. 

You will like Dermassage for other reasons, too. A body rub with it saves your time 
and energy. Massage is gentle, smooth and fast. You needn't follow-up with 
talcum and there is no greasiness to clean away. It won't stain or soil linens or 
bed-clothes. You can easily make friends with Dermassage— send for a sample! 

Now available in new, 16 ounce plastic container with convenient flip-top closure. 



^An^AM -^U^Ki^ a^LAO'tWL'thu cUUtn.i.y^.tt^ 




^iHtjM. 




APRIL 1%9 




LAKESIDE LABORATORIES (CANADA) LTD. 
64-Colgate Aven ue • Toronto 8, Ontario 

THE CANADIAN NURSE 25 




New 11th Edition! Bergersen-Krug 

PHARMACOLOGY 
IN NURSING 



The most widely adopted pharmacology text in Schools of Professional 
Nursing, this classic maintains its reputation for excellence in its new 1 1 th 
edition. Stressing that the good nurse must understand drug action, the 
authors present physiological foundations of drug action, dosages, methods 
of administration, abnormal reactions, and other vital information in a 
logical, coherent format. This new 11th edition includes sound current 
clinical and theoretical findings, the latest drugs accepted for general use, and 
an entire new section on psychotropic drugs. 

By BETTY S. BERGERSEN, R.N., M.S., Ed.D., Associate Professor of Nursing, College 
of Nursing, University of Illinois at the Medical Center in Chicago; and ELSI E S. KRUG, 
R.IM., M.A., Instructor in Pharmacology and Anatomy and Physiology, St. Mary's 
School of Nursing, Rochester, Minn. In collaboration with ANDRES GOTH, M.D. 
Publication date: June, 1969. Approx. 672 pages, 7"x 10", 50 illustrations and 7 
color plates. About $9.75. 



The cap 

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commitment... the book is 



A New Book! 



Williams New 6th Edition ! 



Smith 



NUTRITION 
AND DIET 
THERAPY 

Consider this new patient-centered 
text for your course in "Nutrition 
and Diet Therapy"! Clear, 
understandable discussions relate 
the chemistry of foods, human body 
functions, and physiological and 
emotional needs to each other and to 
overall nursing care. Sections cover 
scientific principles and their clinical 
applications, the role of nutrition in 
public health, in the basic nursing 
specialties, and in clinical 
management of disease. 

By SUE RODWELL WILLIAMS, 
M.R.Ed., M.P.H., Instructor in Nutrition 
and Clinical Dietetics, Kaiser Foundation 
School of Nursing; Nutrition Consultant 
and Program Coordinator, Health 
Education Research Center, Permanente 
Medical Group, Oakland, Calif. 
Publication date: March, 1969. Approx. 
684 pages, 7"x 10", 117 illustrations. 
Price, $9.85. 



PRINCIPLES OF MICROBIOLOGY 

Choose an important text for this important course — Principles of 
Microbiology is the most widely adopted book in "Microbiology" 
courses in Schools of Professional Nursing. Clear, logically oriented 
discussions communicate the microbiological foundation your students 
will use in their clinical experience: concepts of infection, sepsis, 
immunity and many other aspects of the disease process. This new 6th 
edition includes such timely topics as DNA and RNA, and the body's 
protective mechanisms. 

By ALICE LORRAINE SMITH, A.B., M.D., F.C.A.P., F.A.C.P., Associate 
Professor of Pathology, The University of Texas Southwestern Medical School, 
Dallas, T-ex. Publication date: May, 1969. Approx. 672 pages, 7"x 10", 207 
illustrations. About $10.20. 



New 2nd Edition! 



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MICROBIOLOGY LABORATORY 
MANUAL AND WORKBOOK 

An effective sequence of 29 practical exercises, this manual, correlated 
with Principles of Microbiology, follows the popular framework of its 
previous edition: (1) time, (2) reference sources, (3) intention, (4) tools 
(5) technique, and (6) observations. The convenient punched and 
perforated format now incorporates an increased number of 
illustrations and tabulations. 

By ALICE LORRAINE SMITH, A.B., M.D., F.C.A.P., F.A.C.P., Publication date: 
May, 1969. Approx. 168 pages, 7'^"x ^QW, 11 illustrations. About $4.25. 



A New Book! 



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PSYCHOLOGY & SOCIOLOGY: 

An Integrated Approach to 
Understanding Human Behavior 

This unique new book can meet your need for 
an interdisciplinary approach to the 
individual and his behavior in society, 
specifically nursing-oriented. The 
well-rounded presentation considers man as a 
social and psychological whole. Eight realistic 
case studies point out that it is often more 
important for the nurse to know what kind of 
patient has a disease than what disease the 
patient has. A complementary Teacher's 
Guide and Test Manual will be supphed to 
instructors adopting this text. 

By GEORGE KALUGER, Ph.D., Professor of 
Psychology and Education, Shippensburg State 
College, Shippensburg, Pa.; and CHARLES M. 
UNKOVIC, Ph.D., Chairman and Professor of 
Sociology, Florida State Technological University, 
Orlando, Fla. Publication date: May, 1969. Approx. 
496 pages, 7" x 10", 42 illustrations. AboutS10.85. 



Jensen's HISTORY AND TRENDS 
OF PROFESSIONAL NURSING 

The new 6th edition of the most widely adopted text 
for "History of Nursing" courses presents the latest 
trends and factual information in historical 
perspective. Focusing on the relationship of 
contemporary events and historical fact, it covers such 
timely events as: recent uniting of nurses for higher 
wages and economic security; new role of the nurse 
clinician; and place of the community college in 
nursing education. 



By GERALD J. GRIFFIN. R.N., 
Dept. of Nursing, Bronx 
Community College of the City 
University of New York; and H. 
JOANNE GRIFFIN, R.N., B.S., 
M.A., Instructor, Oiv. of Nurse 
Education, New York University. 
Publication date: March, 1969. 
Approx. 360 pages, 7" x 10", 62 
illustrations. About $8.75. 



B.S., M.A., Former Head, 



the symbol of ours 

New 2nd Edition! 

WORKBOOK AND STUDY GUIDE FOR MEDICAL- 
SURGICAL NURSING-A Patient-Centered Approach 

This carefully revised workbook correlates with the number one text on 
Medical-Surgical Nursing, Medical-Surgical Nursing by Shafer, Sawyer, 
McCluskey and Beck. Use it to help your students develop essential clinical skills^ 
communication arts, and problem -solving techniques. 

By ALMA L. JOEL, R.N., B.S.N.; MARJORIE BEYERS, R.N., B.S., M.S.; LOIS S 
CARTER, R.N., B.S.N.; BARBARA PURAS, R.N., B.S.N.; MARY ANN PUGH 
RANDOLPH, R.N., B.S.N.; and DOROTHY SAVICH, R.N., B.S. Publication date: April 
1969. Approx. 320 pages, 7%" x 10%", 13 illustrations. About $5.45. 



New 2nd Edition! Lerch 

WORKBOOK FOR 
MATERNITY NURSING 

The leading workbook for "Obstetric 
Nursing" courses, this new edition 
presents facts of conception and birth 
and techniques and procedues of 
maternal care. Punched, perforated 
format is convenient for both 
instructor and student. Answer book 
supplied free to instructors adopting 
this workbook. 

By CONSTANCE LERCH, R.N., B.S. (Ed.), 
Philadelphia, Pa. Publication Date: April, 
1969. 2nd edition, 303 pages plus FM 
l-VIII, 7V4" X 10>4", 33 illus. Price, $5.40. 



A New Boo/<! Young-Barger 

INTRODUCTION TO 
MEDICAL SCIENCE 

This unusual new book for your 
practical nursing students and 
paramedical trainees explains disease 
in basic concepts of cause and effect, 
in a semi-programmed format. 



By CLARA GENE YOUNG, Technical 
Editor and Writer (Medical), retired, U.S. 
Civil Service; and JAMES D. BARGER, 
M.D., F.C.A.P., Pathologist, Sunrise 
Medical Center, Las Vegas, Nevada. 
Publication date: March, 1969. 295 pages 
plus FM l-XII, 7" X 10", 11 illustrations. 
Price, $8.75. 




... a commitment to provide 
you, the dedicated nursing 
instructor, with a complete line 
of quality nursing textbooks, 
continually revised, expanded, and 
improved to meet YOUR needs, 
YOUR high standards. 

Before you choose textbooks 
for next semester, examine these 
. . . see how they can help you 
fulfill your commitment to 
the future of nursing. 



86 Northline Road • Toronto 16, Ontario 




new products { 



Descriptions are based on information 
supplied by the manufacturer. No 
endorsement is intended. 




Video Monitor / Recorder 

This new line of video monitoring and 
tape recording systems is intended espe- 
cially for hospital installations. 

Applications include monitoring of 
several intensive care patients by a single 
nurse; personnel training; closed circuit 
microscopy (in conjunction with special 
microscopes); evaluation or training in 
operating room procedures; playback of 
religious services into patients' rooms; 
and children's visits to patients via closed 
circuit television. 

The system includes camera, video 
monitor, video recorder, and a supply of 
magnetic tape. The higli quality solid- 
state closed circuit camera operates under 
normal room ligliting and is completely 
transistorized for simple, reliable opera- 
tion and superior picture pickup capabili- 
ties. It can be held in one hand, or 
mounted on a tripod. 

The 9-inch monitor is compact and 
liglitweight. It is designed for panel or 
wall mounting, and has operating controls 
conveniently situated in front. 

The solid state tape recorder receives 
or records broadcasts through a conven- 
tional TV set, its own TV.monitor, or the 
video camera. 

More information may be obtained 
from Dallons Instruments, a division of 
International Rectifier Corporation, 120 
Kansas Street, El Segundo, California 
90245. 

Pediatric Respirator 

This pediatric respirator is designed to 
ventilate newborn, premature, and very 
young children suffering from respiratory 
distress. 

The new Bourns Model LS-104-150 
Pediatric Respirator is a volume limited, 
positive pressure device, and offers a wide 
range of adjustable respiratory functions, 
including breathing and flow rates. Preset 
28 THE CANADIAN NURSE 



volume is adjustable from 5 to 150 ml, 
maximum pressure is adjustable from 15 
to 70 cm H2O, and variable flow is 
adjustable from 50 to 200 ml per second. 
Continuous readouts indicate volume, 
breathing rate, and line pressure to pa- 
tient. 

Two modes of operation are 
provided: 1. In the controlled mode, 
ventilation is fully machine controlled at 
an adjustable rate of 20 to 110 breaths 
per minute. 2. In the assist mode, deli- 
very of a preset volume of oxygen is 
triggered within milliseconds by the in- 
fant's respiratory effort. In this mode, the 
respirator automatically provides con- 
trolled respiration if the infant's own 
respiratory effort stops or falls below a 
predetermined rate for 12 seconds. It 
returns to the assist function as soon as 
spontaneous breathing is resumed. 

Safety features include: apnea alarm 
system, adjustable maximum pressure 
relief valve, and low-pressure alarm to 
indicate system leaks. 

For additional information write: 
Bourns, Inc., Life Systems, 300 Airport 
Road, Ames, Iowa 50010, U.S.A. 

Spoon Holder 

This spoon holder is especially design- 
ed for the patient who cannot close his 
hand to hold a spoon. The holder is 
adjustable to fit all hand sizes. When not 
in use, the spoon is easily removed from 
holder. 

Inquiries or orders regarding this item 
should be directed to your local hospital 
equipment dealer or to Posey Products 
stocked in Canada, B.C. Hollingshead 
Ltd., 64 Gerrard St. E., Toronto 2. 




Silver Swaddler 

The Silver Swaddler is a device for 
preventing hypothermia in the newborn. 
It consists of a simple swaddling-suit of 
polyester plastic film coated with a thin 
layer of aluminum. It is a garment with a 
hood and is supplied with an adhesive 
strip for sealing. Convective and evapo- 
rative heat loss are prevented because the 
material is impermeable; the polyester is a 
poor conductor of heat and the alumi- 




num laminate acts as a silver surface 
preventing radiant heat loss. 

At the time of birth, a baby usually is 
exposed to moderately severe cold stress 
when he emerges naked and wet from the 
warm environment of the uterus. A lusty 
term infant can respond with an abrupt 
fall of his body temperature by tripling 
his heat production. However, in very 
cold conditions or in babies who are 
small, premature, Ul, or asphyxiated, the 
results of cold exposure may be di- 
sastrous. In certain circumstances, some 
degree of cold exposure is almost inevi- 
table, such as during transportation or 
minor surgical procedures. This simple, 
cheap device is useful for keeping babies 
warm when more sophisticated apparatus 
such as an incubator is unavailable or 
inappropriate. 

The Silver Swaddler is available from 
Down Bros, and Mayer & Phelps Ltd., 
410 Dundas St., W., Toronto 2B. C 

APRIL 1969- 




The 

disposable 

diaper 
concept 



What are its advantages? 



In providing greater comfort and safety for 
the infant: 

More absorbent than cloth diapers, "Saneen" 
FLUSHABYES draw moisture away from baby's skin, thus 
reducing the possibility of skin irritation. 
Facial tissue softness and absence of harsh laundry 
additives help prevent diaper derived irritation. 
Five sizes designed to meet all infants' needs from 
premature through toddler. A proper fit every time. 
Single use eliminates a major source of cross-infection. 
Invaluable in isolation units. 



In providing greater hospital convenience: 

Polywrapped units are designed for one-day use, and 
for convenient storage in the bassinet. Also, Saneen 
Flushabyes do not require autoclaving — they contain 
fewer pathogenic organisms at time of application 
than autoclaved cloth diapers.* 
Prefolded Saneen disposables eliminate time spent 
folding cloth diapers in the laundry and before 
application to the infant. Easier to put on baby. 
Constant supply. Saneen Flushabyes eliminate need 
for diaper laundering and are therefore unaffected by 
interruptions in laundry operations. 
Elimination of diaper misuse, which may occur with 

cloth diapers. *The leRlche Bacteriology Study— 1963 



More and more hospitals are changing to Saneen Flushabyes disposable diapers. 

Write us and we will be glad to supply you with further information on clinical studies, cost analysis, and disposal techniques. 

Use these and other fine Saneen products to complete your disposable program: 

MEOICAL TOWELS, "PERIWIPES" TISSUE. CELLULOSE WIPES. BED PAN DRAPES. EXAMINATION SHEETS AND GOWNS. 




aneen 



«J" FKelle Company Limited. 1350 Jane Street. Toronto 15, Ontario. Subsidiary of Canadian International Paper Company e^ COmfOrt • SafOty • COnvenieMCe 

M-H4 "Saneen". •■Flushabyes". "Peri-Wipes" Reg'd T.Ms, Facefle Company Limited 



in a capsule 



Safety Not In Numbers 

A good Samaritan is most likely to be a 
single Samaritan, rather than one of a 
crowd, according to an American study 
reported in The Homer Newsletter. 

People in public are afraid to "lose 
their cool." particularly when they are in 
a crowd. Also the attitude: Nothing can 
be wrong, otherwise someone would try 
to stop it. was given as a reason for 
increased violence occurring without 
anyone nearby trying to stop it. 

Patients Became Gourmets 

A Russian proverb that goes "Drink a 
glass of wine after your soup, and you 
steal a ruble from your doctor," has the 
support of doctors, as well as patients, at 
San Francisco's St. Luke's Hospital. An 
article in the Bulletin of the Society of 
Medical Friends of Wine reports the 
success of an experiment that began at 
the hospital in 1961, with the arrival of a 
chef from a famed restaurant. The 
purpose: to tease the patients' appetites 
with the "arts of haute cuisine developed 
by great culinary artists." The results: 
"Impressive therapeutic benefits to the 
patients, as testified to by their physi- 
cians." 



Women and Water 

Women use water in many places for 
many things - but not to drink, says Dr. 
William F. Mengert, commenting on day- 
to-day problems of obstetrics and gyne- 
cology in the Practical Ob. Gyit 

The reason for this, says Dr. Mengert, 
is that in our culture it is easier for the 
male to find a place to empty his bladder 
than for the female. Consequently, a 
woman has learned to be sparing in her 
water intake. 

Dr. Mengert insists on liis private 
patients drinking a minimum of 12 glasses 
(3 quarts) of water a day. 

Among the many feminine ills that can 
be cured by this "cheap and excellent 
medicine," is cystitis, a frequent com- 
plaint of many women. 

The conclusion of this watered-down 
version of Dr. Mengert's article, in his 
own words is: Sell it to her, doctor, sell it 
to her! 



Noisy shoes 

How many hospital personnel realize 

they are guilty of wearing noisy shoes? 

Harriet Faulkner of Mission, B.C., who 




30 THE CANADIAN NURSE 



was a recent daily visitor for six weeks in 
a large hospital, found it interesting to 
notice the number of noisy shoes worn 
by hospital personnel. 

Some of the offenders were student 
nurses, thougli the visitor didn't blame 
them. She asks if the manufacturers of 
white duty shoes are not aware of the 
need for soft leather soles and heels. And 
surely, she says, schools of nursing do not 
advocate hard-soled shoes! 

It is to be hoped that the kicks will go 
to the guilty parties, so that future 
hospital visits will be more pleasant to the 
ear. 



Talking back 

"Talking back" is a term loaded with 
connotations of unruly behavior and 
smart alecky, disobedient children; "feed- 
back," on the other hand, connotes the 
sterile, efficient, controlled world of the 
computer. Both words mean essentially 
the same, however, and psychology and 
art students at the University of Cincin- 
nati are benefitting from an electronic 
device in their classroom that enables 
them to "talk back" to their lecturer. 

The students let their feelings be 
known by signalling to their instructor 
with red and green lights. A monitoring 
device with blinking colored lights, called 
a communicator, is located at the front of 
the classroom. Wires lead from the mon- 
itor to switches controlled by the stu- 
dents. 

"Wlien students become frustrated 
with a lecture or feel 'lost' or just plain 
bored," a psychology instructor at the 
University of Cincinnati, Dorelle Heisel, 
explained, "they can indicate theit 
anxiety by signaUing me on the monitor." 

An instructor can determine the mood 
of his class and ultimately the effective- 
ness of his teaching by specified combina- 
tions of blinking lights, Mrs. Heisel con- 
tinued. "It has been found that only 
about 20 percent of a lecture class is 
listening at any one time. The lecture, 
however, is a valuable medium for com- 
municating information. This 'communi- 
cator' can increase its effectiveness by 
permitting students to influence an ex- 
planation while it is in progress." 

As she sees it, the communicator will 
sensitize instructors to student reactions 
and involve students in the class, since 
they've helped shape it. 

David Cox, a specialist in training 
development at Proctor & Gamble, devel- 
oped the communicator. C 

APRIL 1969 




a little knowledge is not enough . . . 
give teen-agers the facts about menstruation 



Some teen-agers have heard they shouldn't bathe 
or wash their hair during their menstrual periods. 
Some think unmarried girls should n't use tampons. 
Others say exercise brings on "cramps." No 
wonder they call it the "curse." 

Give them the facts . . . with the help of the 
illustrations in charts like the one above prepared 
by R. L. Dickinson, M.D. and available to you free 
from Canadian Tampax Corporation Ltd. These 
81/2" X 11" colored charts are laminated in plastic 
for permanence and are suitable for marking with 
grease pencil. Social myths can be exploded, too, 
by giving teen-agers either of the two booklets we 
will be glad to send you in quantity fordistribution. 
One bookietiswrittenfortheyounggirl just begin- 
ning menstruation and the other for the older 
teen-ager. The booklets tell them what menstrua- 
tion is, how it will affect them, and how easily they 
can adjust to it normally and naturally. 

Unmarried girls, of course, can use tampons. And 
they have many good reasons to do so. Tampax 
tampons are easy to insert— comfortable to wear. 

APRIL 1969 



Because they're worn internally there's no irrita- 
tion or chafing; no menstrual odor. 

Tampax tampons are available in Junior, 
Regular and Super absorbencies, with explicit 
directions for insertion enclosed in each package. 

TAMPAX 

tAmponA 
SANITARY PROTECTION WORN INTERNALLY 

MADE ONLY BY CANADIAN TAMPAX CORPORATION LTD., BARRIE, ONT. 

FREE CHARTS IN COLOR 

Canadian Tampax Corporation Ltd., P.O. Box 627, Barrie, Ont. 

Please send tree a set of the Dickinson charts, copies of the 
two booklets, a postcard for easy reordering and samples of 
Tampax tampons. 



Name_ 



Address. 



THE CANADIAN NURSE 31 



OPINION 



Nursing assistants are here to stay 



Dorothy J. Kergin, Reg.N., Ph.D. 



Society has granted to nursing the 
right to determine the conditions for 
attaining and retaining membership in the 
profession, through control of the con- 
ditions for registration as a nurse. To be 
identified as a profession also implies that 
nursing exerts a measure of control over 
the manner in which its services are 
rendered. In return for both, nursing is 
responsible to society for providing its 
services as effectively and as efficiently as 
possible. Whenever a profession proposes 
a change in its educational standards for 
entry, in the conditions for remaining, or 
in the manner in which its services are 
rendered, it must ask itself if these 
changes are in the best interests of 
society as a whole. 

Nursing is not fulfilling its responsibi- 
lity to society if it advocates that educa- 
tional programs to prepare practical 
nurses or nursing assistants be discon- 
tinued. At the Canadian Nurses' Associa- 
tion's 34th general meeting in July 1968, 
delegates approved a recommendation of 
the Committee on Nursing Education 
that "all programs which prepare prac- 
titioners, who, upon graduation are not 
eligible for licensure as registered nurses, 
be phased out," adding only the word 
"gradually" to the original recom- 
mendation.* 

Since the proposal is directed toward 
nursing assistant programs, it must be 
considered ill-conceived and poorly 
timed. A decision such as this, which has 
profound social and economic effects for 
society and for nursing, should be based 
upon a scientific study, or at least upon a 
careful assessment of all the factors in- 
volved. There is no real evidence that the 
CNA has done this. 

The proposal lacks rationality for the 
following reasons: 

1 . // (Joes not address itself to the 
problem of more effective utilization of 
the nurse. All individuals who are in- 
capacitated by illness, injury, or senes- 

* Identity and Destiny - in Saskatoon, Canad. 
Nurs.. 64 33, Aug. 1968. 
APRIL 1969 



cence do not require personal care from a 
registered nurse. Many patients confined 
by disability to the home, hospital, or 
nursing home can be maintained and 
moved toward rehabilitation through the 
ministrations of someone with lesser 
preparation than that required for regis- 
tration as a nurse. This assumes, of 
course, that a professional registered 
nurse assesses the patient's needs for 
nursing care, formulates a plan for this 
care indicating the level of skill re- 
quired to expedite it - and periodically 
evaluates the progress made by patient 
and family. 

Let us not try to eliminate a category 
of personnel, but, rather, let us refine the 
criteria with which a professional nurse 
can judge what level of skill is required to 
provide therapeutic nursing care. 

2. The proposal does not recognize 
the public 's concern for the rising costs of 
medical care services, for both iu-hospital 
and extra-hospital care. A major part of 
the nursing profession's responsibility for 
insuring that its services are rendered 
efficiently as well as effectively is con- 
cerned with the optimal utilization of 
lesser skilled personnel. Can the public 
afford to pay, or will it pay, for high cost 
professional nursing services when lower- 
priced non-professional services can 
adequately meet many of their require- 
ments for nursing service? Indeed, how 
well have we documented the need for 
professional nursing care at the patient's 
bedside? 

3. The proposal does not appear to 
recognize that the health care industry is 
one of the largest industries in Canada. At 
a time when many occupational fields 
require individuals to have preparation 
beyond secondary school, the health field 
continues to offer opportunities for those 
who have not attained this level. Dis- 
continuing nursing assistant programs 
would mean that a satisfying work role 
was denied a number of Canadians who 

Dr. Kergin is Associate Director, McMaster 
University School of Nursing, Hamilton, Ont. 



had not had full educational opportu- 
nities. 

The Canadian Nurses' Association has 
forthrightly spoken out against recruiting 
nurses to Canada from countries where 
there is a real shortage of nursing person- 
nel. Instead of recruiting nurses, why 
cannot this nation recruit individuals who 
lack the educational prerequisites to enter 
nursing but who would qualify to enter a 
nursing assistant program'.' These indi- 
viduals would thereby enter a useful 
occupation and share the pleasures of life 
in our democratic society. 

4. The elimination of the formal edu- 
cational programs that prepare nursing 
assistants would fail to do away with this 
level of nursing personnel The responsi- 
bility for educating nursing assistants 
would be left to the institutions that 
employed them. Not only would this 
contribute to the costs of patient care but 
it would also lead to educational pro- 
grams planned by institutions to meet 
their unique and present requirements for 
staff 

What is the answer? Where should the 
Canadian Nurses' Association be directing 
its influence? Let us, as Association 
members, encourage projects that at- 
tempt to define more clearly the roles 
and responsibilities of all levels of nursing 
personnel, to examine present nursing 
practice and identify what functions the 
nurse should legitimately perform in the 
changed world of tomorrow, and to 
consider how nursing can contribute most 
effectively to the delivery of health care. 
We cannot turn back time - the nursing 
assistant is here to stay. If we do not 
determine how best she can be utilized, 
others will do it for us. 

The Canadian nursing profession has a 
right to expect that the Canadian Nurses' 
Association policies will be loudly pro- 
claimed and broadly interpreted to in- 
fluence health policies and practices. Any 
proposal such as this one that contravenes 
the realities of today and tomorrow may 
well weaken the profession's influence 
among employers and in society at large. 
THE CANADIAN NURSE 33 




And now your income tax.. 



A few general rules of the game and some specific details that are of 
interest to nurses. 



By April 30, 1969 over seven million 
Canadians are expected to file personal 
tax returns for the year 1968. The federal 
government has estimated that these re- 
turns will produce personal income tax 
revenue, including old age security tax, of 
approximately $4.2 billions. In addition, 
the federal government will collect over 
$1 bilhon in income taxes on behalf of 
the provinces other than Quebec. (All 
provinces impose a personal income tax 
on its residents; Quebec alone administers 
and collects its own provincial income 
tax.) Although these rough figures may 
be too large to convey any personal 
impact, most taxpayers have found that 
their share of this total represents a 
significant personal sacrifice. 

Qver the years, the Canadian tax sys- 
tem has been amended many times to 
correct obvious inequities and to provide 
a number of special incentives. Taxpayers 
who wish to take advantage of these 
provisions to minimize their tax liability 
or to defer the payment of tax until some 
future time should, therefore, have some 
understanding of these rules and plan 
their financial affairs accordingly. 

It is not possible to outline here all of 
the rules applicable to every individual 
taxpayer. There are, however, a number 
that are of general application and these, 
together with more specific details of 
particular interest to members of the 
nursing profession, are the subject of this 
article. 
34 THE CANADIAN NURSE 



Frederick S. Mallett, C.A. 

Who is taxable? 

Generally, Canadian income tax is 
imposed upon the world income of per- 
sons resident in Canada at any time in the 
year. Citizenship is not a determining 
factor in establishing liability for Canadi- 
an tax and, in this respect, Canadian 
practice differs from that of the United 
States, which imposes tax on all US 
citizens, wherever resident. The first 
problem that may face a taxpayer, there- 
fore, is whether or not he is resident in 
Canada and, if so, for what period. 

Since the solution to this question 
frequently requires reference to a mass of 
court decisions, legal advice may be re- 
quired. In the simple case, however, a 
person is normally resident in the place 
where he has his usual home and where 
he is employed or carrying on a business 
or profession. Canadian citizens who are 
living and employed in Canada are, there- 
fore, subject to Canadian tax. Immi- 
grants, however, are subject to Canadian 
tax on their world income earned only in 
the period of their residence in Canada. 
Similarly, persons giving up their Canadi- 
an residence, although not necessarily 
their Canadian citizenship, are subject to 
Canadian tax only on income received 
during the period prior to their departure. 

Persons subject to Canadian tax for 

Mr. Mallett is a partner in the Ottawa office of 
Clarkson, Gordon & Co., Chartered Account- 
ants. 



part of a year only are not entitled to the 
full personal exemptions provided in the 
Income Tax Act, but rather to a pro rated 
exemption based upon number of days' 
residence in Canada. It is beyond the 
scope of this article to deal further with 
the complex problems that may face 
non-resident taxpayers. The following dis- 
cussion is therefore aimed at the great 
majority who are resident and employed 
in Canada throughout the year. 

Two classes of personal taxpayers 

There are two distinct classes of tax- 
payers and the rules determining income 
are somewhat different for each class. 
Most taxpayers are classed as employees, 
and generally the determination of their 
income subject to tax is fairly simple. 
Normally employees may use the abbrevi- 
ated tax return form Tl Short provided 
they are not engaged in other business 
activities or earn over $2,500 in invest- 
ment income. 

Self-employed persons, and this class 
would include private duty nurses, are 
subject to tax on their net income after 
deducting expenses necessary to their^ 
business or profession. These persons 
must use the Tl General return. All 
taxpayers are subject to the same rules 
with respect to investment income, per- 
sonal exemptions, medical expenses, and 
charitable donations, and, of course, to 
the same rates of tax. 

The task facing employees in comput- 
ing their liability for tax is simplified by 

APRIL 1969' 



the reporting requirements of the Income 
Tax Act, which imposes upon the 
employer an obhgation to furnish each 
employee with a summary of earnings for 
the year, the amount of tax deducted at 
source, and the amounts of contributions 
to registered pension plans and to the 
Canada or Quebec Pension Plan. Each 
employee should receive two copies of 
this report (form T4) before the end of 
February. Other copies are provided by 
the employer to the Department of Na- 
tional Revenue for checking purposes. 




Self-employed persons must maintain 
■their own accounting records to establish 
income received in the year and expenses 
incurred in earning income that may be 
deducted for tax purposes. Generally, 
individual taxpayers must compute in- 
come and expense on a cash basis, that is, 
on cash actually received or actually 
disbursed during the year. 

Income from employment that is sub- 
ject to tax includes salary as well as the 
value of board, lodging, or any other 
oenefit received by virtue of employ- 
;Tient. There are. however, certain bene- 
fits that are specifically excluded, such as 
employers' contributions to pension 
ilans. group sickness or accident insur- 
mce plans, medical plans, and payments 
inder group term life insurance policies. 

Employees are entitled to very few 
leductions in computing their income 
ither liian minor amounts for annual fees 
5aid to professional associations. This 
general restriction prevents, for example, 
1 nurse employed in a hospital from 
leducting the cost of uniforms that she 
las been required to purchase herself, 
iowever. if a nurse is provided with 
iniforms by her employer without char- 
;e, the Department does not require that 
he value of this benefit be included in 
ncome. A self-employed nurse is entitled 
o deduct the cost of uniforms in com- 
•uting her professional income. 

Employees generally may not deduct 
VPRIL 1969 



automobile expenses or other transporta- 
tion costs, since it is assumed that the 
cost of getting to and from work is a 
personal responsibility. If an employee is 
required to use an automobile in the 
performance of his or her duties and is 
reimbursed on a mileage basis, the reim- 
bursement is not included in income 
unless the amount received is obviously 
excessive. 

Some employers prefer to give lump 
sum car allowances that are not directly 
related to actual business use. In these 




cases the allowance can be included in 
income but a deduction may be claimed 
for actual expenses incurred. However, it 
is unlikely that expenses could be claimed 
significantly in excess of the allowance 
given, since the allowance was probably 
determined by the employer to be reason- 
able in the circumstances. 

Self-employed taxpayers, on the other 
hand, may deduct transportation costs 
related to the earning of income. A 
private duty nurse, for example, should 
be able to deduct the cost of driving from 
her home to the places where she renders 
professional services. In such cases, auto- 
mobile expenses would include gas and 
oil, maintenance, tires, insurance, licence 
fees, and capital cost allowance (deprecia- 
tion). Depreciation may be claimed at a 
normal rate of 30 percent of the unde- 
preciated cost of the automobile. 

Since automobiles are rarely used en- 
tirely for business or professional pur- 
poses, taxpayers wishing to claim auto- 
mobile expenses are required to maintain 
a mileage log recording the date, mileage, 
destination, and purpose of each business 
trip. Business mileage for the year may be 
determined and expressed as a percentage 
of total mileage driven. This percentage 
must then be applied to the total of 
automobile expenses incurred to deter- 
mine the amount deductible for tax 
purposes. Taxpayers must be able to 
support automobile expenses, as well as 



other expenses claimed with invoices, 
cancelled cheques or receipts, although 
these need not be filed with the tx\ 
return. 

Income from other sources 

In addition to employment or profes- 
sional income, income from other 
sources, such as interest, dividends, estate 
or trust income, the income portion of 
annuities, and alimony or separation 
allowances, must be included. Although 
all amounts are taxable, no matter how 
small, many taxpayers have apparently 
failed to report bank interest or dividends 
unless they have received a T5 slip from 
the paying source. This year the Depart- 
ment of National Revenue has extended 
its reporting requirements so that all 
interest or dividend payments over SIO 
must be reported. Previously the lower 
limit had been SI 00. As a result, many 
taxpayers may have received T5 slips, 
which report such minor items as bank 
savings account interest, for the first time 
this year. 

Taxpayers should not forget to include 
the value of bond coupons cashed during 
the year, whether or not a T5 slip has 
been received, particularly if an informa- 
tion slip (form T600) was filled out as 
required at the time the coupon was 
cashed. 

The following additional points should 
be kept in mind when calculating tax on 
investment income. 

1. Interest: Interest on bank bor- 
rowings may be deducted if the borrowed 
money was used to purchase income- 
producing investments or property. 
Interest may be deducted in such cases 
even if the amount of interest paid in the 
year exceeds the amount of income re- 
ceived. 

2. Other Carrying Costs: Other costs 
applicable to investment income are 
deductible, such as safety deposit box 
rentals, one-half of the fees charged by 
investment counsel, and, if necessary, 
professional accounting fees paid during 
the year. 

3. Depletion Allowances: Dividends 
received from companies engaged in 
extra-active industries, such as mining, oil 
and gas. may be reduced by depletion 
allowances at various rates. In most cases, 
the depletion allowance rate is shown on 
the T5 slip; if not, the rate may be 
obtained by calling the local office of the 
Department of National Revenue. 

4. Twenty Percent Dividend Tax 
Credit: Taxes may be reduced by 20 
percent of the net dividend income 
received (that is after deducting appli- 
cable carrying costs and depletion) from 

THE CANADIAN NURSE 35 



taxable Canadian corporations. This 
credit is intended to offset in part the tax 
paid by the corporation on its earnings 
prior to the dividend distribution. But it 
also serves as an incentive to invest in 
Canadian equity securities. 

Personal exemptions 

Every taxpayer is entitled to personal 
exemptions of varying amounts com- 
mencing at $ 1 ,000 (unless reduced in the 
case of part-year residents). Although 
these exemptions are described in some 
detail on the return itself, some further 
explanations may be useful. 

Although working wives whose income 
is over $1,250 may not be claimed as 
dependents by their husbands, it should 
be remembered that this limitation 




applies only to income received after 
marriage. Thus, a working girl earning 
$400 per month who was married on 
October 15, 1968, could be claimed as a 
dependent by her husband. In this case 
the exemption would be $250 ($1,250 
less $1,000 earned after the wedding). 
This newly married woman must also file 
her own return for the year, reporting 
income of $4,800 and claiming the basic 
exemption of $1,000. 

When both parents are working, the 
question is sometimes asked as to which 
parent may claim the children as depen- 
dents. Normally it is advantageous for the 
spouse with the larger income — usually 
the husband - to claim the children; 
because of the progressive tax rate struc- 
ture, the exemption would result in a 
greater tax saving. It is, however, a 
question of fact as to which parent is 
financially responsible for the children's 
support and, therefore, in some cases the 
wife may claim the exemption. 

Medical expenses and charitable dona- 
tions may be claimed subject to certain 
limitations. Every taxpayer may claim 
either (a) a standard deduction of $100 
36 THE CANADIAN NURSE 



or (b) actual medical costs incurred on 
behalf of the taxpayer and his depen- 
dents, less 3 percent of net income, plus 
donations made to registered Canadian 
charities. 

Medical expenses may be claimed if 
they were paid during any 12-month 
period ending in the year, provided, of 
course, that they were not claimed 
previously. Medical expenses include 
amounts paid on behalf of the taxpayer 
by medical or hospital insurance plans, 
except amounts paid by provincial hospi- 
tal insurance plans. In Ontario, for 
example, supplementary hospital benefits 
paid by Blue Cross may be claimed, but 
not amounts paid by the Ontario Hospital 
Services Commission. 

To be deductible, charitable donations 
must be paid to registered Canadian 
charities and must be supported by 
receipts showing the registration number 
of the organization. There are, however, 
minor exceptions to this rule covering 
donations made to certain US charities, if 
the donor commutes to work in the US 
or has income from US sources. 

After completion, tax returns must be 
filed on or before April 30 along with a 
cheque payable to the Receiver General 
of Canada for any unpaid tax. Many 
prefer to complete their tax returns as 
quickly as possible so that they will be 
processed early. If tax is payable, 
payment may be deferred until April 30, 
even though the return has been submitt- 
ed earlier. If a refund is due, the sooner 
the return is filed the sooner the refund 
cheque will be received. Any tax unpaid 
after April 30 is subject to a 5 percent 
penalty plus interest. 

A look at the future 

What can be done to reduce tax in 
1969? Many taxpayers are unaware of 
the tax savings (more properly a deferral 
of tax to some future date) that may be 



achieved through Registered Retirement 
Savings Plans. These plans are generally 
available through insurance companies, 
trust companies, and mutual funds, and 
provide a wide variety of investment 
objectives and other features. Contribu- 
tions are deductible for tax purposes up 
to certain prescribed limits. The fund 
itself is exempt from tax so that the 
growth rate of the portfoUo is higher than 
would otherwise be possible. Following 
retirement, benefits in the form of an 
annuity will be subject to tax, but pre- 
sumably at a lower rate than would have 
been paid had the contributions been^ 
taxed as earned. 

These Registered Retirement Savings 
Plans are of particular interest to self- 
employed persons who may not enroll in 
registered employee pension plans; 
however employees who wish to set aside 
more than permitted under their pension 
plan may wish to use a Registered Retire- 
ment Savings Plan as a supplement. 

Although further tax saving measures 
may be applicable in certain circum- 
stances, the reader should understand 
that the federal government is now in the 
process of completing a review of the 
substantial and challenging recommenda- 
tions made by the Carter Royal Commis- 
sion on Taxation in 1966. There is some 
indication that many of the Commission's 
recommendations may be adopted, a1 
least in modified form, but no precise 
details are expected to be available unti! 
June 1969 at the earliest. In all probabil- 
ity we will have a new Income Tax Act ir 
effect by 1970. 

At this stage one can only speculate as» 
to how the new Act will affect tht 
individual taxpayer, other than to suggesi 
that income tax will continue to absorl 
an increasing proportion of persona 
income. Therefore, awareness of th(' 
impact of taxation remains an importan' 
first step in financial planning. C 




APRIL 196' 



Medicolegal problems can arise 

in the coronary care unit 



A nurse working in a coronary care unit should be aware of all the medicolegal 
implications involved in the care of her patients, and take measures to protect 
herself from charges of malpractice. 



Gloria G. Crotin, B.N., M.N.Ed. 



In carrying out a nursing procedure in 
any clinical area, a nurse can be sued if 
damage results to the patient. The action 
against her would be successful if the 
damage were caused by negligence on her 
part. In the coronary care unit, the 
possibility of the nurse being sued for 
malpractice is increased, since she often is 
called on to perform functions that can 
mean life or death for the patient. 

In some coronary care units, particu- 
larly those in small community hospitals, 
there is a danger that the nurse may be 
required to make emergency decisions 
and to perform functions that are not 
entirely nursing in nature. In this event, 
she could be in difficulty in three 
areas: 1. She is vulnerable to legal action 
taken by the patient for malprac- 
tice; 2. She is vulnerable to legal action 
taken by the medical profession in that 
she carried out an unauthorized prac- 
tice; 3. If she carries out an unauthorized 
practice, she could be guilty of profes- 
sional misconduct within the regulations 
of the nursing profession. 

Problems facing the nurse 

A patient is admitted to the coronary 
care unit with a diagnosis of myocardial 
infarction, coronary thrombosis, or a 
suspected heart problem. While in the 

Mrs. Crotin, a graduate of McGill University 
and the University of Pittsburgh, is now Direc- 
tor of Nursing at York Central Hospital, Rich- 
mond Hill. Ontario. 



unit he may or may not develop com- 
plications, such as a major cardiac ar- 
rhythmia. 

A major arrhythmia presents the 
greatest problem, since it may lead to 
ventricular standstill or ventricular fibril- 
lation. In either event, someone — prefer- 
ably the doctor, but all too often the 
nurse — must intervene. 

If the doctor is not available when 
such an emergency arises, the nurse is 
forced to make an immediate decision 
concerning her patient's treatment; her 
decision will depend on her assessment of 
his condition. Does he have cardiac stand- 
still or cardiac fibrillation? 

In this crisis, the nurse may decide to 
apply external thoracic compression or 
apply an electrical defibrillator to the 
heart. She may make a wrong assessment 
and thus apply an incorrect treatment, 
such as giving an electrical countershock 
when it is not indicated, or failing to 
apply external thoracic compression 
when it is indicated. 

The nurse is faced with another 
dilemma if the patient goes into cardio- 
genic shock or cardiac decompensation. If 
the physician is unavailable, she then has 
to decide whether vasopressor drugs are 
required and when. She also has the task 
of administering these drugs intrave- 
nously if a doctor is not present. 

Even if the nurse selects the correct 

course of treatment, damage to the 

patient may follow. External thoracic 

THE CANADIAN NURSE 37 




38 THE CANADIAN NURSE 



compression may be accompanied by 
damage to the heart, such as a contusion 
of the myocardium, rupture of the heart 
or hver, or fractured ribs with possible 
lung penetration. The use of vasopressor 
drugs, such as metaraminol bitartrate can 
lead to severe tissue damage if the med- 
ication inadvertently extravasates. 

Protective measures 

A review of law cases reveals few 
charges against nurses who have expanded 
their functions into the area of general 
medical practice, and few charges against 
physicians who have delegated to nurses 
functions that are beyond the education 
of a nurse. However, this does not lessen 
the importance of the nurse being pro- 
tected against lawsuit. 

Many of the protective devices used in 
the past are outdated and need to be 
revised, if they are to provide legal 
protection. For example, some provincial 
nursing acts do not define nursing prac- 
tice; in addition, few medical or hospital 
associations have issued statements of 
policy in conjunction with the provincial 
nurses' association to support the nurse's 
activities in the coronary care unit. 

Nursing Practice Act: Every province 
in Canada has its own nursing act. These 
acts, which are designed to protect the 
public by demanding certain respon- 
sibilities from the nurse, usually provide a 
definition of professional nursing; a few, 
however, do not. The acts grant minimal 
rights to the nurse, such as the placement 
of the initials RN following her name. 
Most of the acts permit the nurse to do 
almost anything in the medical area as 
long as it is prescribed by a physician or 
done under his direction or control. 

A definition of professional nursing 
practice is essential, for it limits the area 
of professional nursing and protects the 
nurse from the charge of unlicensed 
practice of medicine, if she performs only 
those functions that are defined by the 
act. 

The statutory definition of nursing 
within any province may determine a 
nurse's responsibility for injury to a 
patient. For example, questions of relia- 
bility for damages may relate to the 
nurse's power of observation of symp- 



toms, such as the observation of a patient 
going into cardiogenic shock. Reliability 
questions may arise from the recording of 
facts. The nurse may record a wrong 
pulse rate or electrocardiographic reading. 
She also runs into problems if she fails to 
carry out prescribed treatments and med- 
ications, such as those suggested forr 
ventricular fibrillation. The nurse is also 
responsible for safeguarding the patient's 
safety. 

The tendency for the courts is to 
follow past issues or similar ruhngs in 
other provinces for malpractice suits 
brought against a nurse. These com- 
parable rulings may persuade a judge, but 
any decisions in the future that involve a 
nurse in a coronary care unit will 
probably be based on the nurse's edu- 
cational background and preparation, 
how she carried out a given procedure, 
and whether this procedure was within 
the framework of the hospital's policies 
and the physician's instructions. 

Joint Statements: Further protectioi 
for the nurse working in a coronary can 
unit may be provided by the issuing of a 
joint statement on the nurse's functions 
by various professional associations. Foi 
example, the California Medical Associa- 
tion, California Nurses' Association, and 
the California Hospital Association issued 
a joint policy statement as follows: 

"We recognize the propriety of registere 
nurses to use monitoring, defibrillation, and 
resuscitative equipment and to institute im- 
mediate life-saving corrective measures, if a 
licensed physician is not immediately available 
to do so and the following conditions 
exist: 1. The registered nurse has had special 
competent instruction in the tech- 
niques. 2. The registered nurse performs the 
authorized procedures upon: (a) the direct 
order of a licensed doctor of medicine, oi 
(b) pursuant to standing procedures established 
as set forth in item 4. following. 3. Where a 
hospital has determined that a registered nurse 
may perform the techniques, then the tech- 
niques to be performed within the framework 
of designated preparation and practice of the 
nurse shall be established for the hospital by 5 
committee composed of representatives from 
the medical staff, the department of nursing. 
and the administration. Thus the framework ol 
preparation and practice shall be reproduced in 

APRIL 1969 



writing and made available to the total medical 
and nursing staffs. 4. Such criteria shall make 
provision that in case of a cardiac emergency, a 
licensed physician and other designated catego- 
ries of personnel are to be immediately 
summoned to assist the registered nurse who is 
carrying out the physician's orders or is carry- 
ing out standing procedures established by the 
medical staff of the hospital, and contained in 
the adopted criteria."^ 

Malpractice Insurance: The nurse in a 
coronary care unit should purchase a 
malpractice insurance policy. The usual 
policies provide her with two benefits. 
First, the insurance company bears the 
cost of defending and representing her in 
court. Second, most liability policies state 
that the insurance company will pay for 
all losses incurred by the nurse, including 
settlements made out of court, up to the 
face value of the policy. 

In some countries registered nurses can 
purchase professional liability insurance 
through their professional nurses' associa- 
tion. The maximum limit is from one to 
two hundred thousand dollars payable on 
each claim, with a limit on the number of 
claims in one year. 

Future problems 

It is quite likely that nurses may soon 
be involved in establishing the time of 
death of a patient. Clinical death occurs 
when there are no observable or percepti- 
ble vital signs of life, such as heart beat, 
respiration, and, in rare instances, brain 
wave activity. Within an interval of time 
after clinical death, usually three or four 
minutes, it is possible in some instances 
to restore respiration and heart beat 
through the use of external heart mas- 
sage, artificial respiration, and drugs. This 
all must be done before irreversible brain 
damage occurs. The nurse now records 
the time of clinical death (cardiac stand- 
still) and the physician records the time 
of medical death. 

The mechanical failure of any of the 
various monitoring devices that assist in 
sustaining life, such as the deliberate 
interruption of a pacemaker or a negli- 
gent interruption of the pacemaker that 
results in death, may present legal prob- 
lems. Failure to provide competent resus- 
citative procedures after clinical death 
APRIL 1969 



may lead to further legal problems.2 

While nurses are becoming familiar 
with external cardiac massage and the use 
of cardiac defibrillators, physicians and 
researchers are busy developing new heart 
drugs and advanced equipment. What 
problems these will bring is not known, 
but some surmises can be made. 

For the treatment of cardiogenic 
shock, an intra-aortic balloon is already 
being tested.3 The balloon, which con- 
tains helium, assists the heart by acting as 
a pump. It is predicted that future coro- 
nary artery disease patients may have this 
balloon inserted immediately upon admis- 
sion to the coronary unit. There is a 
major hazard with the balloon: if it 
bursts, it may cause an embolus. 

Another device is the solo hyperbaric 
chamber or unit." This is a single bed unit 
capable of delivering high concentrations 
of pure oxygen. Physicians believe they 
can halve the death rate from acute 
myocardial infarctions with the use of 
this apparatus. It, too, is not without 
hazards. 

A safe environment 

When working in a coronary care unit, 
the nurse should assure herself that she is 
practicing within an environment that is 
safe for herself as well as for the patient. 

• Each registered nurse should have her 
own liability insurance policy. 

• Records showing monthly equipment 
checks for conductivity and correct 
grounding should be kept by the engi- 
neering department. 

• Nurses' notes should be descriptive and 
frequent. The time of observations, 
treatments, and electrocardiograph read- 
ings is extremely important. 

• There should be written policies on the 
procedures to be followed when cardiac 
arrest or any other problem occurs. The 
policies should be developed by means of 
a coronary unit committee with register- 
ed nurses represented. The committee 
should meet on a regular basis to discuss 
current problems and to assure con- 
tinuing education of physicians and 
nurses. 

• The advanced education and pre- 
paration of the nurses who work in the 
unit should be recorded for future refer- 



ence. Any additional continuing educa- 
tion should be recorded also. 

• The nursing practice act for each 
specific province should be reviewed to 
find out if the nurse is practicing within 
the definition of nursing practice or if she 
is practicing medicine. 

• The nurse should look for the support 
of various professional organizations and 
joint statement policies by these organ- 
izations and joint statement policies by 
these organizations on cardiopulmonary 
resuscitation and other life-saving 
measures she may be confronted with in 
the unit. 

References 

1. Acute Cardiac Care; The Role of the Regis- 
tered Nurse. (Joint statement by the Cali- 
fornia Medical Association, California Hospi- 
tal Association, California Nurses' Associa- 
tion.) California Medicine CIV, March 1966, 
p.228. 

2. Houts, M. and Haul, l.H. Death: Courtroom 
Medicine. New York, Matthew Bender and 
Company, 1966, p.3. 

3. Balloon lightens heart's workload. Medical 
World News 9:43, May 24, 1968. 

4. Hyperbaric Unit puts pressure on heart 
deaths. Medical World News 9:65, May 24, 
1968. 

Bibliography 

Caswell, .I.E. A brief history of coronary care 
units. Public Health Reports 82:1105-1107, 
Dec. 1967. 

Downs, F.S. Technical innovation and the 

future of the nurse-patient relationship. 

ANA Clinical Sessions American Nurses' 

Association. New York, Appleton-Century- 

Crofts, 1966. 
Ferrigan, M. A new nursing horizon. Int. Nurs. 

Rev.. 13:19-20, March-April, 1966. 
Jones, B. The patient and his responses. Amer. 

J. Nurs. 67:2313-2320, Nov. 1967. 
Nite, G. and Willis, F.N. The Coronary patient: 

Hospital Care and Rehabilitation. New 

York, The Macmillan Co., 1964. 
Phibbs, B. The Human Heart. St. Louis. The 

C.V. MosbyCo., 1967. 
Pinneo, Rose. Nursing in a coronary care unit. 

Cardio- Vascular Nursing 3:1-4, Jan.-Feb., 

1967. 
Linger, P.N. and Jenkins, A.C. Guidebnes for 

planning a coronary intensive care unit. 

Hospital Progress 57:89-96, August, 1966. 
Whalen, R.E. and Starmer, C.F. Electric shock 

hazards in clinical cardiology. Modern Con- 
cepts of Cardiovascular Disease 36:7-12, 

Feb. 1967. Q 

THE CANADIAN NURSE 39 



Smoking habits of 
Canadian nurses and teachers 



Although the proportion of nurses and teachers who smoke habitually is lower 
than that of the national average, those who do have the habit smoke more 
heavily than other Canadians. 



A.J. Phillips, Ph.D. 



"I don't smoke. Top speed requires 
top condition," says Al Pease, Canadian 
racing driver. "Smoking and sports don't 
mix," says Elaine Tanner, one of Can- 
ada's top swimmers. Nancy Greene, 
Olympic and World Champion skier, says 
simply: "I don't smoke." 

Personality posters displaying testi- 
monials such as these along with a photo 
of the star in action are distributed by the 
Canadian Cancer Society as part of their 
campaign against smoking. They are 
aimed particularly at young people, who 
are known to be greatly influenced by 
persons they respect or admire. 

Whether doctors, nurses, and teachers 
live up to the expectations of the general 
public or not, there is no doubt that 
Canadians think that these persons should 
be above reproach in matters of health 
and morals. The example shown by a 
single doctor, nurse or teacher can make 
the difference between a nonsmoker 
starting to smoke or not and a seasoned 
smoker giving up the habit or continuing 
it. As far as smoking is concerned, how- 
ever, doctors certainly do not act as 
examples to the rest of the population. A 
recent survey of doctors' smoking habits 
revealed that about one out of three 
smoke cigarettes regularly and that doc- 
tors smoke, on the average, considerably 
more cigarettes per day than cigarette 
smokers among the rest of the Canadian 
population. ■" 

The following study of Canadian 
40 THE CANADIAN NURSE 



nurses and teachers was carried out to 
discover how their smoking habits com- 
pare with those of other Canadians. 

Fewer nurses and teachers smoke 

Each provincial registered nurses' as- 
sociation was invited to select every 
thirtieth name from the mailing list, 
beginning with the seventh name. All 10 
provinces agreed to participate. A cover- 
ing letter, questionnaire, and self-address- 
ed envelope were sent to 3,557 nurses, 
and 1,901 (53 percent) submitted com- 
pleted questionnaires. 

Each provincial teachers' association 
was invited to select every 100th name 
from its mailing list, beginning with the 
seventh name. All provinces with the 
exception of British Columbia agreed to 
participate. The necessary materials were 
sent to 1,227 teachers, and 792 (64 
percent) submitted completed question- 
naires. 

The first question asked was, "Would 
you classify yourself as a smoker, ex- 
smoker, or nonsmoker? " The results as 
shown in Table 1 were: 28.7 percent of 
nurses and 29.2 percent of teachers 
classified themselves as smokers; 14.9 
percent of nurses and 12.2 percent of 
teachers classified themselves as ex- 
smokers; and 56.4 percent of nurses and 

Dr. Phillips is Assistant Executive Director 
(Statistics) at the National Cancer Institute of 
Canada in Toronto. 



58.6 percent of teachers were non- 
smokers. 

A study conducted by the Dominion 
Bureau of Statistics for the Department 
of National Health and Welfare revealed 
that 35.6 percent of Canadian women 
and 59.6 percent of Canadian men over 
20 years of age smoke cigarettes. 2 It 
would appear, therefore, that the pro- 
portions of nurses and teachers who are 
cigarette smokers are below that for 
Canada. 

Of the 545 nurses who classified them- 
selves as smokers, 504 or 92.6 percent 
reported smoking cigarettes regularly, and 
257 (90.8 percent) of the 283 who 
classified themselves as ex-smokers, said 
that they used to smoke regularly. 
Among teachers, 207 (89.6 percent) of 
231 smokers smoked cigarettes regularly, 
and 89 (91.8 percent) of the 97 ex- 
smokers had done so. 

Of nurses who smoked at one time, 
34.2 percent had given up smoking, and 
29.6 percent of teachers who smoked at 
one time had given up the habit. As 
shown in Table II, approximately one- 
quarter of nurses and teachers have de- 
creased their daily consumption. Offset- 
ting this, however, is 24.7 percent of 
teachers and 14.8 percent of nurses who 
have increased their daily consumption. 

More heavy smokers 

Table III shows an analysis of th& 
average number of cigarettes smoked pei 

APRIL 196^ 



day and indicates that heavy smoking - 
over 20 cigarettes per day — is more 
common among nurses and teachers than 
among the rest of the Canadian popu- 
lation. Whereas 9.9 percent of Canadian 
men and 4.3 percent of Canadian women 
smoke more than 25 cigarettes daily, 30.3 
percent of teachers and 31.7 percent of 
nurses smoke more than 20 cigarettes per 
day. 3 

As shown in Table IV, a little more 
than one-third of nurses and teachers gave 
up smoking because of scientific evidence 
that smoking is injurious to health; about 
one out of eight nurses and one out of 
five teachers gave up smoking to relieve 
respiratory ailments; and about one out 
of 12 nurses and teachers stopped 
smoking because of illness. 

Not setting example 

This study of a random sample of 
nurses and teachers in Canada revealed 
that 28.7 percent of nurses and 29.2 
percent of teachers smoke cigarettes. In 
view of the mass of scientific evidence 
relating cigarette smoking to cardio- 
vascular and bronchopulmonary disease. 
and the unique position of members of 
these professions as examples to others, it 
is difficult to understand why such high 
proportions continue to smoke cigarettes. 
The continuance of the habit indicates 
that many are not fulfilling their roles as 
models to their patients and students. 

There is evidence also that heav\ 
cigarette smoking is more common 
among both nurses and teachers than 
among the general population. In the 
present study, only 20.7 percent of 
nurses who smoke and 21.6 percent ot 
teachers who smoke consume fewer than 
10 cigarettes daily; the Canadian study 
showed that this figure is 27.8 percent for 
the population at large. Conversely, 31.7 
percent of nurses who smoke and 30.3 
percent of teachers who smoke consume 
over 20 cigarettes per day, compared to 
7.8 percent in the Canadian study (based 
on more than 25 cigarettes per day). 

The study shows a decrease in ci- 
garette smoking among both groups; 34.2 
percent of nurses and 29.6 percent of 
teachers who smoked cigarettes at some 
time have stopped. Approximately 40 
percent of the participants said that they 
stopped smoking because of the scientific 
evidence that cigarette smoking is hazard- 
ous to health. However, about 22 percent 
of nurses and 30 percent of teachers were 
under some pressure to give up the habit, 
as refiected by those who mentioned 
relief from respiratory symptoms or 
illness. 

Although a proportion of nurses and 
APRIL 1969 




TABLE I 

Classification of Nurses and Teachers 
by Smoking History 



TABLE III 

Daily Cigarette Consumption 
by Amount Smoked 



1 

t. 


Nurses 


Teachers 




Canada 


Smoking 

History 

1 


No. 


% 


No. 


% 


Amount 
Smoked 
per Day 


Nurses 

7c 


Teachers 

% 


Males Females 

% % 


' Smoker 
Ex-smoke 
Nonsmoker 


545 

283 

1,073 


28.7 
14.9 
56.4 


231 

97 

464 


29.2 
12.2 
58.6 


Under 10 
cigarettes 

10-20 
More than 20 

No Data 


20.7 

31.9 

31.7 
15.7 


21.6 

34.2 

30.3 
13.9 


21.8 

68.3 
9.9 


37.9 

*57.8 
**4.3 


Total 


1,901 


100.0 


792 


100.0 




1 




*11 - 25 cigarettes per day 
**over 25 cigarettes per day 







^^^^^^TABl^^^ 


^^1 


^^^^tlassification of Smokers ^^^H 


f by Change in Habit ^| 


[' Nurses 


Teachers 


Change in Habit 


No. 


%■ 


No. 


% 


Decreased daily 










consumption 


156 


28.5 


58 


25.1 


Increased daily 










consumption 


81 


14.8 


57 


24.7 


No change 


237 


43.9 


99 


42.8 


Data omitted 


71 


12.8 


17 


7.4 


'Total 


545 


100.0 


231 


100.0 


L» 



teachers has given up cigarette smoking, 
out of every three nurses and teachers 
who still smoke, one smokes more than 
20 cigarettes a day. It is clear that neither 
of these professions can hope to influence 
other Canadians to give up smoking. 

References 

1. Phillips, A.J. and Taylor, R.M. Smoking 
habits of physicians in Canada. Canad. Med. 
Assoc. J. 99:19:955-957, Nov. 16, 1968. 

2. Canada. Department of National Health and 
Welfare. Smoking habits of Canadians. Ot- 
tawa, Queen's F^nter, 1964, p.l2. 

3. Ibid., p. 14- 15. n 



^^^ 


TABLE IV 






Classification of Ex-Smokers 




by Causative Factor 




Nurses 


Teachers 


Causative 












No. 


% 


No. 


% 


Factor 










(a) BeHef in 










scientific 










evidence 


112 


39.6 


37 


38.1 


(b) ReUef of 










respiratory 










symptoms 


36 


12.7 


21 


21.6 


(c) Illness 


25 


8.8 


8 


8.2 


Combination of 










(a) and (b) 


28 


9.9 


14 


14.4 


Combination of 










(a) and (c) 


3 


1.0 


4 


4.3 


Combination of 










(b) and (c) 


1 


0.4 


- 


- 


No data 


78 


27.6 


13 


13.4 


Total 


283 


100.0 


97 


100.0 





THE CANADIAN NURSE 41 



Hemodialysis in the home 



Artificial kidney treatment in the home offers a new lease on life to many 
patients with chronic renal failure. 



Sheila Wood, S.R.N., S.C.M. 



For many patients with chronic renal 
failure, use of the artificial kidney has 
meant a definite prolongation of life. 
Even so, this method of treatment is not 
without its problems. 

First, the cost of operating dialysis 
units is prohibitive; second, a limited 
number of beds are available for treating 
these patients, even though there are now 
many hospital-based dialysis centers; and 
third, few trained staff are available to 
operate these units. Fortunately, these 
problems are being solved to a certain 
extent by teaching the patient and at 
least one member of his family to carry 
out dialysis in the home. 

Program al MCH 

Such a program has been in effect at 
The Montreal General Hospital since 
August, 1966. We have 21 patients, 
whose ages range from 14 to 62 years, 
carrying out their own dialysis in their 
homes. Four of these patients live in the 
United States, and three in New Bruns- 
wick; the remainder are Quebec residents. 

The patient selected for home dialysis 
is one who has a capable spouse, parent, 
or other relative willing to undertake the 
responsibility of working the machine. 
Ideally, the patient should be in reason- 
able health apart from the renal failure - 

Miss Wood, a graduate of The Queen Elizabeth 
School of Nursing, Birmingham, England, is on 
the staff of the dialysis unit at The Montreal 
General Hospital. 



42 THE CANADIAN NURSE 



although we have found that vascular 
disease, such as angina, is not contraindi- 
cated - be in his own home, preferably a 
house, and have a job that he can retain 
even after many absences; in other words, 
he has to be a useful member of society. 

After admission to the dialysis unit at 
MGH, the patient has an arteriovenous 
shunt (AV shunt) inserted. When possi- 
ble, the shunt is inserted into the leg as 
this gives the patient a greater degree of 
independence when he begins and com- 
pletes dialysis. He is in hospital for about 
three weeks, during which time hemo- 
dialysis is begun and a regular routine of 
twice-weekly treatments established, to 
give a total dialysis time of about 30 
hours weekly. 

The patient and his relative are taught 
to take and record blood pressure and 
temperature, to observe the shunt for 
clotting, and to give catheter care. If the 
patient is well enough at this time, he 
then learns how to begin his dialysis. The 
dietitian helps him to make the most of 
his restricted diet, which usually allows 
him 60 mg. of protein, 20 Gm. sodium, 
and 60 mEq. potassium. Fluids are 
restricted to 400 ml. daily, or free fluids 
according to the urinary output. 

As soon as the patient is mobile, he 
and his relative come to the unit every 
day except Sundays for about six weeks. 
It must be remembered that few patients 
or their relatives know anything about 
medical matters, and learning to take and 

APRIL 1969 



record a blood pressure is a feat for them. 
We are fortunate to have three registered 
nurses among the wives of our patients, 
and one patient is a doctor. The length of 
time for patient teaching also depends on 
the intelligence and confidence of the 
people concerned. 

Every aspect of patient care is taught, 
from the sterile technique necessary for 
beginning dialysis to the giving of blood 
and saline into the venous drip chamber. 
During the first two weeks, the patient 
and his relative learn to prepare the tank 
that contains the dialysate fluid, and to 
build and sterilize the artificial kidney. 
The relative observes the nurses on the 
unit and how they deal with situations as 
they arise. 

At this stage, the patient is usually 
beginning and ending dialysis himself. 
Routine monitoring is then taught, and 
the patient learns what to do when one of 
the alarms rings. Emergencies, such as a 
blood leak through the cuprophane 
membrane or shock due to excessive 
weight loss, are covered. Each section is 
repeated as many times as necessary. 

During the last two weeks, the patient 
and his relative carry out the treatment in 
a completely separate room located three 
floors from the dialysis unit. This gives 
them the feeling of being independent, 
although they are still linked to the unit 
by telephone and can call a nurse on the 
unit, if necessary. 

Before going home, the patient and his 
APRIL 1969 



relative are given a multiple-choice ques- 
tion test; after they have successfully 
passed this test, they return home, 
accompanied by the nurse who has been 
teaching them. She stays with them for 
the first dialysis, after which they are on 
their own unless they have any special 
problems. 

The patient keeps in touch with the 
dialysis unit by telephone. He sends 
specimens of serum, taken before and 
after his weekly dialysis, to the unit, 
along with dialysate fluid and whole 
blood for hematocrit determination. 
Analysis of these specimens is made at 
the hospital, and any abnormality is 
noted by the doctor, who immediately 
calls the patient. 

Every two months the patient returns 
to the hospital and visits the renal clinic, 
where he is examined. Here, he has an 
opportunity to discuss any problem he 
might have encountered during dialysis. 
Patient histories 

One of our youngest patients, CD., is 
a 1 5-year-old boy with hereditary 
nephritis, which resulted in chronic renal 
failure. There was a strong family history 
of the disease, so CD. was discovered 
early and followed for several years. For 
two years he was managed on a low 
sodium diet, fluid restrictions, and drugs, 
such as Amphojel, calcium, Apresoline 
Hydrochloride, Aldomet and gua- 
nethidine sulphate. He was usually hyper- 
tensive (BP 160/100) but managed to feel 



fairly well. CD. was followed carefully at 
clinic; when his blood urea nitrogen 
(BUN) reached 200 mg./lOO ml. and his 
creatinine 20 mg./lOO ml., he was 
brought into hospital for initiation of 
hemodialysis. (Normal BUN: 10-20 
mg./lOO ml.; normal creatinine level: 
0.7-1.5 mg./100 ml.). 

Peritoneal dialysis was done first for 
57 hours, and this brought his BUN down 
to 60 mg./lOO ml. and removed six 
pounds of fluid. An AV shunt was in- 
serted and hemodialysis begun. His 
mother came to learn to run his artificial 
kidney, and CD. lumself learned to 
manage the equipment and begin and end 
dialysis. He is now at home with his 
dialysis equipment and managing well, 
after a few initial problems concerning 
the family's water supply. He goes to 
school and is showing good progress. 

Mrs. P.M., of Vermont, a 55-year-old 
business woman, has chronic glomeru- 
lonephritis. As her disease progressed, it 
became necessary to begin hemodialysis. 
Mrs. P.M. is a widow and lives with her 
elderly, incapacitated mother. The 
problem was, who would look after her 
and stay with her while she was dialyz- 
ed? 

Fortunately, she has a daughter and a 
daughter-in-law, both with young fam- 
ilies, who arranged to learn together and 
to take turns to help with Mrs. P.M.'s 
dialysis. The three cooperated well and 
learned quickly, so that after 10 weeks of 
THE CANADIAN NURSE 43 




Mr. L. on dialysis in his own home. Everything needed for his comfortis at hand: he can 
sit and read, watch television, or sleep, safe in the knowledge that his alarm system will 
warn him of any irregularity. 



Home Dialysis Equipment. This complete unit shows: 1. the heparin pump; 2. the 
dialyzer;3. the flow restrainer; 4. the venous pressure line; and 5. the control unit with 
alarms. 




traveling to and from Montreal twice a 
week, they were ready to go home. 

Mrs. P.M. has now been home for 16 
months; her blood chemistry is well- 
controlled by twice-weekly dialysis, she 
works full time, and has only returned to 
the unit on one occasion for dialysis. 

Program successful 

Home dialysis has proven very success- 
ful; the rate of infection is virtually nil, 
and problems over dialysis and equipment 
are few. The patient likes to be at home 
with his family, and, with a little intelli- 
gent organization, there need be only a 
small amount of disruption to the family 
routine. The patient on home dialysis 
does not have to worry about traveling to 
and from the hospital, and persons who 
would otherwise be too far from a dia- 
lysis unit to make hospital dialysis prac- 
tical, can benefit. 

Each month a "Newsletter" is sent to 
each patient with news and views from 
the medical and nursing staff and from 
the patients themselves. A favorite in- 
clusion is salt-free recipes and a list of 
restaurants that serve salt-free meals. 

One major problem, the cost, is being 
adequately met by some provincial 
governments; however, patients in other 
provinces have to rely on insurance, 
kindly firms, or wealthy relatives. 
The cost of the basic equipment is: 

Tank, pump & control box $ 837. 

Kiil dialyzer and stand $ 905. 

Heparin pump $ 160. 

Centrifuge $ 86. 

Total $1,988. 

The annual cost of thrice-weekly dia- 
lysis in the home is $3,500, after an 
initial cost of $2,500 for the basic equip- 
ment and alterations in the home. This is 
approximately one-quarter of the cost for 
each patient on dialysis in hospital. 

At present, the dialysis unit at The 
Montreal General Hospital is the only 
unit in Eastern Canada that has patients 
receiving dialysis in the home. Similar 
programs are being started in Ottawa and 
Hamilton, Ontario, and in Vancouver, 
British Columbia; there are, of course, 
many hospitals that offer hemodialysis in 
the hospital. 

Home dialysis makes it possible to give 
a new life to many more people than 
would otherwise be possible. We believe it 
is a practice that will increase rapidly in 
the near future. D' 



THE CANADIAN NURSE 



APRIL 1969 



idea 
exchange 



Communal 
Dining 



Patients in nursing homes or homes for 
the aged frequently are apathetic about 
feeding themselves, and this apathy 
follows a set pattern. The indifference is 
more pronounced where the resident eats 
in his own bed. or alone at the bedside 
from a tray, without social interaction. 
He begins to toy with his food, eating less 
and less. When this persists, the nurse 
often gives help to provide a sufficient 
caloric intake. This, of course, does not 
improve the situation; the resident lacks 
the appetite, or is too weak, or enjoys the 
attention of the nurse too much to make 
the effort. He now enters in the down- 
ward spiral toward total dependency — 
that of being fed. 

Since this indifference to eating often 
takes so much time, the nurse may resort 
to minced or pureed food. The resident 
has now reached a low ebb with the loss 
of dignity and worth. This usually com- 
pletes the picture of total regression. 

The road back to self-feeding is a 
difficult one, because pride and self- 
esteem must first be restored. The indivi- 
dual must be handled delicately, and with 
tact. A habit has to be broken. 
APRIL 1%9 




The nurse begins by setting goals that 
can be reached, so as not to discourage an 
already indifferent person. Once the 
patient starts to accept the change in 
routine, he can be introduced to fellow 
diners and the dining room. 

In spite of careful introduction, some 
residents are confused when they face the 
change, but they do adjust under the 
guidance of a helpful nurse. First at- 
tempts at feeding can be just as painful as 
they were long ago, but just as rewarding. 
Residents slowly graduate to a higher 
level, step by step. Plates are introduced 
with minced, then solid food; later the 
patient releams how to manage knife and 
fork. Patience is required during the 
releaming stage. 

The indifference pertains to other 
activities of daily living as well as eating. 
Eating cannot be divorced from these 
other activities because the whole picture 
has to improve. One of our residents was 
extremely reluctant to leave her room 
and refused to eat in the dining room. 
She was encouraged tactfully and pa- 
tiently to try crafts. One day, six months 
later, after a busy afternoon of work and 
socializing, she demanded her right to eat 



at the table with the rest of the ladies. 

If possible, the dining area should be 
subdivided into two or three smaller 
areas. This can be achieved with shoul- 
der-high, moveable screens or plant 
dividers, or even just larger separations 
between tables. The reason: eating habits 
or the ability to manage utensils varies 
among patients; some patients are ill at 
ease in the presence of less able eaters. 

It is a good idea to precede mealtimes 
with brief entertainments, to set the 
mood for sociability. At our hospital, 
grace is said by a resident and a short 
lesson is read. Low background music 
also improves the atmosphere. 

Mealtime should be a special event. 
Tables must be attractively set, and a 
gracious dining room atmosphere should 
prevail. Much is gained by this step. 

Results speak for themselves. In 
August 1967, 30 percent of our patients 
had to be fed by staff; in May 1968, only 
14 percent needed to be fed; and in July 
1968, only 11 percent. - Mrs. Vera 
Mclver, Director of Hospital Services, St. 
Mary's Priory Hospital, Victoria, B.C. D 



THE CANADIAN NURSE 45 



books 



Countdown 1968. 151 pages. Ottawa, 
Canadian Nurses' Association, 1968. 
Reviewed by Mary L. Richmond, Di- 
rector of Nursing, The Vancouver Gen- 
eral Hospital, Vancouver. B. C. 

"What happens to all the statistical 
data I send the CNA each year about 
myself and our agency? Does anyone 
ever do anything with them? " 

Yes! Their collection and orderly 
arrangement in Countdown 1968 makes 
very interesting and provocative reading. 
It also provides a base for trend pre- 
diction, which is fundamental to both 
personal and agency planning. 

How does your turnover rate compare 
with that of other places in your pro- 
vince? How does your province compare 
with the rest of Canada? Is there a way 
of estimating turnover rates that makes it 
possible to compare one setting with 
another? You will find answers to some 
of these questions in Countdown 1968. 
How does the percentage increase in 
auxihary personnel compare with the 
increase in registered nurses? 

Compare your percentage of head 
nurses having baccalaureate degrees with 
that of other hospitals your size. 

Also find out the answers to these 
questions: Are we, as a country, progress- 
ing far toward improving the educational 
standing of our service and teaching 
personnel? How many of our nursing 
supervisors have academic degrees? How 
do our salaries from province to province 
compare among various categories of 
nurses? Is there a place for male nurses in 
Canada? How many are there? 

Countdown 1968 is the sequel to 
Countdown 1967 and is a publication of 
the Canadian Nurses' Association. It is a 
compilation of a great deal of statistical 
information about nursing personnel in 
Canada. Its 151 pages contain 133 tables 
with well-worded headings; the contents 
and text are evidence of the cooperation 
between individuals and data-gathering 
agencies. 

There is little text, but a brief back- 
ground note and an identification of 
highlights and trends emerging from the 
tables introduce each section. 

While the tables have obviously been 
prepared by a statistician, one need not 
46 THE CANADIAN NURSE 



be a statistician to understand and 
appreciate them, or to have one's 
curiosity aroused. The explicit titles and 
headings of the tables, plus the brief 
notes in the text, make the data meaning- 
ful to both the nurse who is not a 
statistician and the non-nurse. The back- 
ground material explains our "universe of 
professional discourse." This explanation 
is essential both to the non-nurse and the 
nurse not particularly familiar with the 
vocabulary or the peculiarities of the 
nursing world. For example, there is an 
explanation of postbasic programs in 
nursing and of educational programs for 
nursing assistants. 

The publication serves both as a source 
book for locating specific data and as 
thought-provoking reading - preferably 
taken in not-too-large doses. 

Countdown 1968 provides essential 
data for those engaged in long-range 
planning. For those who like to "wonder 
why," it opens up vast areas of further 
inquiry. 

The real value of this publication will 
derive from what we as a profession and 
we as a nation do with it! 

Read, wonder, and perhaps, with me, 
thank our national office for providing 
one more tool in helping to construct 
health services for Canadians. 



Textbook for Midwives, 6th ed.. by 
Margaret F. Myles. 792 pages. Edin- 
burgh & London, E. & S. Livingstone 
Ltd., 1968. Canadian Agent: Macmil- 
lan Co. of Canada, Toronto. 
Reviewed by Molly Evans. Clinical 
Instructor in Obstetrics, Royal Colum- 
bian Hospital, New Westminster, B.C. 

The 6th edition of Miss Myles' text- 
book of midwifery is testimony to her 
profound interest and sound knowledge 
of the art and practice of all facets of 
midwifery, and to her ability to teach. 

This fascinating subject is presented 
under eight headings and approached 
from basic female anatomy, the physiolo- 
gy of the reproductive cycle, the develop- 
ment of the fertilized ovum, the placenta, 
and fetus. 

The major sections of pregnancy, 
labor, and the puerperium are subdivided 



from normal physiological changes to the 
clinical application of such change for the 
protection of the mother and baby. The 
role of the midwife in caring for the 
family is carefully elucidated; she prac- 
tices only within the law and limit of the 
Midwives Act. Therefore the normal sec- 
tion of each subject is immediately 
followed by deviations from the normal, 
and the early recognition of such devia- 
tions is emphasized. 

The major asset of this text is the 
presentation of the subject matter; it is 
clear, concise, in logical sequence, and, 
consequently, provides easy reference. 

This new edition contains up-to-date 
information on the "high risk" group of 
mother and babies and the Saling method 
of amnioscopy and fetal blood sampling 
along with other research projects that 
have been perfected in the past two years. 
A suggested outline of an educational 
program for parents in preparation for 
parenthood is interesting. The first dis- 
cussion group is to be held at six to eight 
weeks gestation, subsequently at 20 
weeks, and then each two weeks until 36 
weeks gestation. Actual techniques of 
preparation for labor are astutely sum- 
marized as a wise precaution against 
emphasis of "method" as opposed to 
education as a basis for sound pre- 
paration. 

Illustrations and diagrams are ex- 
cellent. Some photographs unfortunately 
are sadly out of date and do little to 
enhance the image of the midwife. 

Canadian nurses working on the 
obstetrical team would find the book an 
excellent, if selective, reference. 

Introduction to Human Embryology by 

James Blake Thomas, Ph.D. 348 pages. 
Philadelphia, Lea & Febiger, 1968. 
Canadian agent: Macmillan Co. of 
Canada Ltd., Toronto. 
Reviewed by Carol L. Mc William, 
Instructor, The University of New 
Brunswick, Fredericton, N.B. 

In this book, the author has met his 
objective of "describing human prenatal 
development within a broad frame of 
reference." Using this as a criterion, the 
book might be considered a success. 
(Continued on page 48) 
APRIL 1969 




In Press Now - Ready Soon 

The most widely used textbook of pediatric nursing in the United States — now thoroughly revised and 
updated 

Marlow: Textbook of Pediatric Nursing New 3rd Edition 

As nursing instructors throughout the country know, Dr. Marlow's text is unex- 
celled for its connprehensive treatment of the growth, development, and nursing 
care needs of the sick and well child from birth through adolescence. For each 
stage of development, Dr. Marlow discusses physical and emotional growth, 
normal behavior patterns, health requirements, the functions of the nurse, con- 
ditions requiring immediate, short term, or long term care and their nursing 
requirements. Throughout the book, the author gives special attention to the 
nurse's role in dealing with the emotional problems of the child patient and his 
parents. This New (3rd) Edition maintains and even increases the all-around 
excellence that has earned this text its position of leadership in the field. 

By Dorothy R. Marlow, R.N., Ed.D., Deon ond Professor of Pediatric Nursing, College of Nursing, 

Villanova University. 

About 730 pages with about 350 illustrations. About $9.5